The Ace Process — more time, more money, and more freedom

Dr. Albert (Ace) Goerig discusses the major goals of the Ace Process

Over the past 20 years, there have been many changes in our endodontic technology and the way we treat patients. During the same 20-year period, even with all these changes, profitability has decreased, practices have declined, and endodontists are more stressed than ever. They are still working 4 or 5 days a week with very few real vacations. As an endodontic coach, I have reviewed over 20% of all the endodontists’ numbers in the country during that same time. I have found that in the single-doctor practice, about 80% have an average production between $700,000 and $900,000 with the average net ranging between $300,000 and $450,000 — basically, an overhead of 50%. These endodontists are completing, on an average, three to four cases per day. If they consistently complete seven cases per day, they are in the top 10% of all the endodontists in the country. (To determine your daily case average, divide the number of completed cases done this year by the number of days worked.)

When I asked these endodontists to time themselves to see how long it takes to treat a four-canal molar, most of them would say it would take about an hour. Then I asked, If you are working a 9-hour day, why are you not completing nine cases? Some have no answer, but others will say they had too many cancellations or no-shows; patients who did not need treatment were in treatment slots or too many side bookings and difficult cases. We can deduce from this that efficiency and profitability are less related to clinical technique and more related to office process. By evaluating and changing a few of their office systems, most endodontists could complete an additional two cases per day and take home another $500,000 a year. The Ace Process has been designed specifically for endodontists and their teams to learn how to do more cases per day with less stress.

Most of the endodontists I have worked with over the years find it easy to change their systems through this process, resulting in increased office profitability and personal peace for both the doctor and the team while having more time to enjoy life. During this process, many of the doctors reduce the days they work by 20 to 50 days a year. Additional benefits are the doctor and team are less stressed, do better clinical cases, and have fun in the office again.

Looking at the results of our coaching clients in 2016, our doctors earned an average increase in net profitability of $467,893 with the lowest increase of an additional $164,184 to the bottom line. One doctor increased his net profit by almost $1.07 million, resulting in a total net profit of $1,372,624. (See the chart.)

It is surprising that these increases did not come from any change in their clinical technique. The average increase above is just two more cases per day. With the right systems and coaching, these doctors found it easier to complete six, seven, or even eight cases a day with less stress than when they were doing only three or four cases per day. Just two additional cases per day provided them with an extra $500,000 per year. These doctors now had the ability to pay off ALL debt within 3 to 5 years, provide higher incomes for their teams, put more toward retirement, donate more to charity, and enjoy more time with their families. If looking at the power of compounding, $500,000 invested every year at 7% over 30 years yields a return of $50,831,000. Not bad for just two more root canals per day.

The answer is in the fine-tuning and redesigning the many systems of the practice. Every practice is unique, and each has different problems. The most effective way to determine what systems need to be modified, fixed, or eliminated is through office observation.

The following are many of the systems that need to be evaluated and adjusted:

  • Scheduling and patient flow
  • Scripting to prevent cancellations, no-shows, and non-treatment
  • Office communication
  • How to present and collect fees
  • Hiring, motivating, and keeping a great team
  • Designating, creating, and empowering team leaders
  • Strong internal and external referral marketing
  • Creating an incredible patient experience
  • Painless and efficient, quality endodontics
  • Simplified monitors to track and understand the numbers
  • Business systems
  • When and how to bring in the “right” associates.

Retiring in practice is the foundation of the Ace Process. This begins with increasing office efficiency to complete two more cases a day ($500k/year), paying off all debt, and bringing in the associate once collections by the owner-doctor reaches $1.4 million per year. At this point, the owner works only 3 days a week, taking 10 to 12 weeks’ vacation each year. With an associate, the practice is always open 5 days a week, having emergency appointments available every day. This is what the referring dentists want, making the practice highly competitive in today’s endodontic market. The greatest mistake endodontists make is bringing in an associate before collections are $1.4 million per year. If they do, there will not be enough work for the associate, and the associate will leave for better pay. If the owner provides enough patients to the associate when there are not enough patients to fill the owner’s schedule, the owner will see a big drop in his/her personal net income.

One of the major goals of the Ace Process is to get a single owner-doctor collecting $1.4 million per year, so he/she can bring in an associate. For some practices this can be done in a year; others may take 2 to 4 years. When this happens, the owner-doctors can have the practice of their dreams, working 130 days a year and securing true personal freedom!

This information was provided by Endo Mastery.

Albert (Ace) Goerig, DDS, MS, is a nationally known speaker who has lectured extensively in his field of endodontics and dental practice management to dentists throughout the United States, Canada, and abroad. He has authored over 60 articles and is a contributing author to the following textbooks: Pathways of the Pulp, Ingle’s Endodontics, and Practical Endodontics. Dr. Goerig is a Diplomate of the American Board of Endodontics and a Fellow of both the American and International College of Dentists. He has been involved in teaching both endodontics and general dentistry residents for many years. He is in private dental practice in Olympia, Washington, specializing in endodontics. In 1996, he co-founded Endodontic Practice Mastery to teach endodontists the business of dentistry while helping them to love their practice. Since then he has personally coached over 22% of all endodontists and their teams in the U.S. and Canada. He is also the co-author of Time and Money: Your Guide to Financial Freedom. He and his wife, Nancy, were married in 1969 and have five children. He has many hobbies, including fishing, scuba diving, skiing, and travel.

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