How to increase your clinical efficiency and profitability


Editor’s intro: For endodontists who want to achieve clinical efficiency and increase revenue, Dr. Albert (Ace Goerig) shows the three main areas to work on in the practice.

Dr. Albert (Ace) Goerig discusses three main areas that may need change in your practice

How is your office doing compared to last year? Most endodontists I talk with are working harder, have lower profitability, are getting fewer and tougher cases, and have greater stress in their practice. By improving office systems and efficiency, most endodontists can significantly reduce their stress and complete one or two more cases per day, which would double their net profit. Even though most endodontists can complete a molar treatment in 1 hour, I have found that the average endodontist completes three to four cases a day. To determine the number of cases you do in the day, take the number of cases you did last year, and divide by the number of days you worked.

Nothing will change from last year unless you change three main areas in your practice:

  1. Marketing
  2. Scheduling
  3. Clinical focus


Most endodontists do minimal marketing, which is the key to practice growth. One of my favorite quotes about marketing is, “Those who need to market should not, and those who don’t need to market should.” You should not market until you have an incredible, caring team that can create the WOW experience, have a clean and up-to-date facility, are committed to seeing patients on time and completing on time, are clinically efficient and strive for excellence, and have openings each day to see emergency patients. When these are in place, then you can start a vigorous marketing plan.

Most marketing plans fail because they are inconsistent and devote too little time to marketing. They have no marketing coordinator and very few strategies. The doctor does not spend enough time creating relationships with his referring doctors and does not commit 2% to 3% of the revenue on marketing.

It is important to assign one of your administrative team members as a marketing coordinator who will be responsible for implementing and managing the marketing program and strategies. Every endodontist needs to create a referral tracking monitor to track the statistics daily, monthly, and yearly. I believe that you need to connect with your important offices each month. In my practice, we go to over 80 offices a month. The marketing coordinator should spend about 12-18 hours per week on these duties. Meet with your marketing coordinator and office manager once a month to review the statistics to ensure the practice is headed in the right direction. Or, conversely, if it’s not headed in the right direction, identify ways to turn it around.


To create an ideal schedule, you must first time yourself in various procedures and sit down with your team to give yourself adequate time to complete each case. Initially, reduce most side bookings, such as diagnosis and emergencies, and leave space open at the end of the day for emergencies, which will become completed cases. When emergency cases are next to treatment, there is not enough time to complete treatment. Many doctors spend too much time on the phone or computer, on team management issues, or just talking too much. Set goals of cases completed each day, and at the end of the day, review the schedule flow with your team leaders, and make appropriate corrections for the next day. It is important that the administrative team understands which patients really need treatment and which should be placed in an evaluation appointment. Time must be taken to educate the administrative team on endodontic triage on endodontic diagnosis.

Clinical focus

Endodontists must focus 98% of their time on direct patient treatment delivery and empower the team to manage the practice and stop wasting 4 to 6 hours a week on practice management. If you empower your team to run your practice, you need only 3 to 4 hours per month for business management.

Clinical efficiency comes from experience and having a step-by-step system of endodontic protocol. This helps your assistants to work hand-in-hand with you, allowing the procedure to flow effortlessly. Don’t lose your focus when you cannot find a canal or get down to length, or even perforate; just know that everything will come together. It is a mindset. When things are not going exactly the way you want, don’t get upset; instead, laugh or use the following words and phrases to refocus and stay on task: “Great!”; “Next!”; “Isn’t that interesting? “or “It is what it is.” Frustration and anger are detrimental in obtaining high quality clinical results and creating a fun and profitable office. Ego and perfectionism are the enemies of excellence, keep us upset, and prevent us from focusing on exactly what we need to do to solve the problem. It also affects our focus on the next patients we see, reducing the quality of care we give our patients.

When the systems really flow well, patients love being in the office, the team loves serving the patients, referrals go up, and endodontics becomes effortless, making the practice fun and profitable. Learn to enjoy the process.

What inspired Ace to guide dentists to clinical efficiency and practice success? Read more about his life here.

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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