Correcting Salary Expenses

Staff salaries are one of the most significant expenses in a dental practice, and reducing wages is not a viable option in today’s competitive hiring market. Instead, practices must increase efficiency and revenue to ensure that clinical staff salaries fall within the appropriate 12-15% of total collections without sacrificing quality of care or staff satisfaction.

Below are actionable strategies to balance clinical salaries and maintain a financially healthy practice.

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1. Increase Revenue Instead of Cutting Salaries

Rather than reducing pay, practices should focus on growing revenue to naturally lower the salary percentage as a portion of total income.

✅ Example:

If a practice collects $1M annually and clinical salaries are $250,000 (25%), reducing that percentage to 15% requires increasing collections to $1.66M rather than cutting wages.

Key Revenue Growth Strategies:

✅ Expand High-Profit Services

• Add clear aligners, implants, sleep apnea treatment, Botox/TMJ therapy, or same-day crowns to boost revenue per patient.
• Train hygienists to identify and introduce treatment opportunities during cleanings.

✅ Market to a Higher-Value Patient Base

• Evaluate insurance participation—does it still make sense to be in-network with low-paying PPOs?
• Consider dropping low-reimbursement plans and shifting toward a fee-for-service model.
• Offer an in-house membership plan to attract patients who will accept treatment at full fee.

✅ Increase Case Acceptance

• Review treatment conversion rates—a high-volume, low-production practice may be underutilizing its potential.
• Implement a team-wide case presentation strategy to ensure patients understand the value of treatment.
• Leverage digital scans and AI-assisted diagnostics to show, not just tell patients what they need.

✅ Dial Up on Marketing & Patient Acquisition

• If patient volume is low, target high-value procedures in marketing campaigns.
• Implement referral incentives to bring in new patients who complete treatment.
• Optimize the practice’s Google Business profile and website SEO to attract more local traffic.

📌 Pro Tip: The goal is to increase revenue per visit rather than just seeing more patients. Running around seeing 50 patients a day without converting treatment doesn’t increase profitability—it just increases overhead.

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2. Maximize Operational Efficiency

A. Optimize Scheduling for Higher Productivity

✅ Reduce Doctor Downtime – Ensure dentists are seeing patients consistently throughout the day with minimal gaps.

✅ Hygienists Should Be Fully Booked – Aim for at least 90% re-care pre-booking to keep hygiene revenue stable.

✅ Stack & Stagger Appointments Efficiently – Maximize chair time by coordinating long and short procedures.

📌 Pro Tip: Practices with excessive doctor days per week but low production should evaluate whether too much clinical time is available for the patient volume.

 

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B. Increase Production Without Adding More Staff

✅ Leverage Expanded Function Dental Assistants (EFDAs)

• Where permitted by law, EFDAs can place restorations, take impressions, and handle lab work, freeing up the dentist to see more patients.

✅ Enhance Hygiene Productivity

• Implement “co-diagnosis” training where hygienists introduce treatment needs before the dentist arrives.
• Ensure hygienists offer adjunctive services (perio treatment, fluoride, whitening, sealants) to increase revenue per visit.

✅ Incorporate Same-Day Treatment

• Use iTero, 3Shape, or Primescan intraoral scanners to present treatment options in real-time and schedule same-day procedures.
• Train the front desk to fill last-minute cancellations with pending treatment cases.

📌 Pro Tip: A practice may not be overstaffed, but rather underperforming in case acceptance and efficiency.

 

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3. Reduce Overhead Expenses to Improve Profitability

While increasing revenue is the primary goal, optimizing non-staff expenses can further balance the practice’s financial health.

✅ Renegotiate PPO Reimbursement Rates

• If insurance adjustments are too high, negotiate with major payers to increase fee schedules.
• If negotiations fail, consider dropping underperforming PPOs.

✅ Reduce Supply Costs

• Use bulk ordering discounts or supplier negotiations to lower material costs.
• Avoid overstocking rarely used items that tie up cash flow.

✅ Optimize Lab Expenses

• Compare lab fees vs. in-house milling options (e.g., CEREC for same-day crowns).

📌 Pro Tip: Cutting overhead by just 3-5% can free up thousands in additional profit without cutting salaries.

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4. Long-Term Strategy: Shift Towards Higher-Profit Dentistry

The best-performing practices focus on high-margin procedures while maintaining an efficient, streamlined workflow.

A. Move Toward Higher-Profit Services

• General Practices Can Add:
• Invisalign, implants, same-day crowns, sleep apnea treatment, and laser dentistry for higher profitability per visit.
• Consider Fee-Based Hygiene Services
• Offer teeth whitening, fluoride varnish, or perio therapy packages to increase revenue per hygiene visit.

B. Consider Reducing Insurance Dependence Over Time

• Practices that drop low-paying PPOs and transition to fee-for-service or in-house membership plans experience higher per-patient profitability.
• Offering flexible financing options (CareCredit, Sunbit) can help patients accept treatment without insurance barriers.

📌 Pro Tip: If the practice is highly dependent on low-fee insurance reimbursements, a gradual transition away from these payers will significantly improve revenue per visit.

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Final Takeaways: The Path to Salary Efficiency

If staff salaries are above 15% of revenue, the solution isn’t cutting pay—it’s boosting practice revenue and efficiency.

📌 Key Takeaways:

✅ Increase revenue through high-margin procedures, better case acceptance, and higher patient value.

✅ Optimize scheduling & provider efficiency—maximize chair time without adding more staff.

✅ Reduce insurance dependence by negotiating rates or shifting toward fee-for-service.

✅ Cut unnecessary overhead costs to improve profitability without cutting wages.

✅ Leverage technology (scanners, AI tools, and digital workflows) to increase case acceptance & same-day treatment.