Episode : #1,172: The Mid-Year Practice Reset: What Needs to Change Before Q4

Podcast Description

Tiffanie and Nikki share what dental practices should be looking at it now that we’re halfway through 2026. Such milestones or touchpoints can include the goals you set at the start of the year, production numbers, the metrics ranges for healthy practices, and so on. From there, Tiff and Nikki talk about how to turn your midpoint numbers into game plans for the remaining six months.

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Transcript:

Tiffanie (00:00)

Hello, Dental A Team listeners. We are back at you again. ⁓ we do four of these ish a month. We do one a week. myself, Tiffanie, and the consulting team. And I always pick from my consultant crew ⁓ whoever can be the best cohort on the topic and also their schedules, which is a fun.

little alignment of ⁓ situations here regarding our topic of choice today. So today I have Nikki. Nikki, thank you for making yourself available this morning for pivoting with me. I know I had some ⁓ travel stuff last week and had to move calls around so we had to move this call around and I just appreciate you so much Nikki and for pivoting and and Nikki I’m gonna I’m just gonna say it. It’s funny.

And we all kind of podcast from wherever we can. We try to ta stay as centralized as we possibly can, but we all at some point or another are in a very different place than our norm. And Nikki has had so many fun spots. So if you are a an avid podcast listener, you’ve heard Nikki’s and you’ve not watched, I want you to go back and like look through all of Nikki’s and see all of her different backgrounds because it’s just so fun.

Nikki Mack (00:55)

Yeah.

Tiffanie (01:09)

you’re like our Carmen San Diego, Nikki. How are you doing today in ⁓ your new space today that is a very temporary and then you’ll have a new new space, but how are you doing over there?

Nikki Mack (01:20)

Yeah, doing great today. ⁓ this may just be my thing. I may have to find somewhere new to podcast from every time. We’ll just yeah. Yes. ⁓ I did love Carmen San Diego, so absolutely I’ll just wear a red hat. You’ll see me out and about. That would be amazing. ⁓ yes, doing good. super happy to be back. I can’t get enough of doing podcasts and

Tiffanie (01:27)

I like it. Or pop something in there that people have to find, like what’s different.

I don’t know.

I love it

Nikki Mack (01:47)

No matter where we are, absolutely we’re here for our listeners and we’re gonna get it done. So I’m ready.

Tiffanie (01:52)

I love

it. I love it. thank you. And listeners, you guys know if you’ve listened to us at all that we truly do love what we do, that we are here to ensure that we give as much information out to the dental world and beyond. We have listeners who aren’t even a part of the dental world because entrepreneurship is all the same. Business is business is how I describe it. So whether you’re dental, whether you’re outside of dental, I know we’ve worked with podiatrists and optimists.

And chiropractors and all kinds of different businesses. We’ve helped CPAs and financial advisors and all kinds of different organizations because at the bottom of everything, business is the foundation here and dentistry is what you do on top of that foundation. So we’re excited for you guys to be here. We’re excited to be ⁓ hosting this podcast to be delivered in July.

July is one of my favorite months of the year for multiple reasons. Brodie’s birthday is in July. He’s actually eighteen ⁓ this year. The the recording of this podcast, he will be eighteen in almost a month from now. So that’s crazy and scary. And for those of you who have been listening for as long as we’ve been doing this, you probably remember when little Brodie, who’s like nine or ten, maybe not even yet, eight, ⁓ came on and he talked about having a working mom. So really cool.

If you’ve been listening for a long time, you know who he is. But July is also one of my favorite months of the year because this is really kind of our reset month. This is where I just kind of slow down in life and in business and really take a look at what are the things I said I wanted to accomplish this year and where am I at in relation to those things? Do I need to pivot? Are did things change? Did I have things on my docket that I was like, gosh, that’s kind of arbitrary or

Too much or you gosh, I’m really just not gonna get to that this year and that’s okay too. So have we changed things that maybe we need to reevaluate and reset? for me personally, I said I’m gonna do a pull up this year, and you what, it’s still on my docket, but six months, seven months into the year, not having made ⁓ a lot of progress on even attempting to do one, I think I’m a little behind the wheel on that. So needing to reevaluate, but that’s really what we’re talking about today. So whether it’s personal goals, business goals

Family goals, whatever they are, this is a really great time of year to just take a step back and really, really, really push forward on what we want our life to look like. So we brought Nikki on today to help us with that as far as the dental industry and the and the dental business. And Nikki, from your perspective, consulting practices, I know this is the time of year as well that we’re gonna take a look with our clients and we say, Hey, how was Q2?

So we’ve already done a how is Q1. We go through, we evaluate quarter one in comparison to last year at the same time. Well that now our consultants are all going through for their clients and really evaluating quarter two in comparison to quarter one and also in comparison to the projections that we made with them earlier this year. So as we’re prepping for that and as we’re getting ready to have those conversations with our clients, Nikki, what are some of the key indicators, the KPIs that you have always loved watching for your practices? ⁓

in consulting, in managing, in working within the DSL world, all of your different spaces, what are the ones that you really like to take a look at in July?

Nikki Mack (05:16)

So for me, I mean, production’s the obvious one, right? Like we never really take our eye off of production ever. Q one, two, three, four, always. ⁓ but I think deeper than just production, it’s looking at those metrics that drive production, especially that we started the year with the intention of working on. So a lot of my offices this year, it’s case acceptance. Like 2026 is all about case acceptance.

Tiffanie (05:23)

Yeah.

Nikki Mack (05:42)

And so for me at this halfway point, that’s where I’m really like digging into that number. So what does the percentage look like? And there’s metrics, right? And there’s ranges and there’s healthy offices and things like that. But like I tell my teens a lot when we first start, the biggest thing I’m looking at is just where are we? So like January, ⁓ if we’ve been together for a while, where our starting point is, your percentage now is what I care about. And then how are we going to increase it? So hopefully by July.

We’ve seen some movement in that number and production would reflect it. But if we don’t understand how we’re driving that production, how do we keep doing it or make those changes? Like we said, going into Q3 that we need. So ⁓ I would say case acceptance is a huge one. Are you tracking dollars? Are you tracking percentage? Whatever we’ve been looking at, let’s really dive into it. And then honestly, another one that I’ve seen a lot lately is ⁓

New patient retention. So we a lot of doctors have expanded or brought in associates or we have a lot of new practice owners, right? And so new patients, we know it, they matter, they’re super important. But if we’re bringing a ton of women and they’re all just leaving and not like staying with us, then like that’s a lot of time invested. ⁓ so we’ve I’ve seen a lot of focus this year with what’s our new patient numbers and then who came back.

So July is a perfect time to really be dialed in on that because we’re going to start to see those six month recares come back, the ones from the end of last year. So that’s a super good number, in my opinion, to really get an eye on the health of your practice and how some of our systems are working. Because I love a system.

Tiffanie (07:27)

Right. All right. That’s what we’re here for, right?

Yeah, I I totally agree. And I love the new patient spot too, like in conjunction with the case acceptance that you said both of those, because oftentimes we will look at the case acceptance and we’ll say, Gosh, I w our case acceptance is really high, but our we’re still not meeting production, or our case acceptance is really low. We’ve got to

Gotta do more ⁓ case ex you know, case acceptance, whatever. But when you start to really dive into it, a lot of times our case acceptance will tell us every time our case acceptance will tell us what our diagnosis is as well, right? So if we’re only looking at what is our percentage of case acceptance, whether it’s dollar or yes or no, it doesn’t really matter. But if we’re only looking at that number and we’re never looking at how much have we diagnosed, we kind of miss the boat there on the in between. So as you’re taking that mid year.

Check-in here in July. I think that that is a great place to start. I totally agree, Mickey. Because at that point you can say, do we have the opportunity to meet the goals that we are projecting towards? So where are we at? We always say go look at what your full goal was or is, right? So what are we supposed to do by December 31st, 2026, or whatever year you’re listening to this in? What are we supposed to do by the end of the year? And where are we at in relation to that? So six months.

Nikki Mack (08:39)

Ha ha

Tiffanie (08:46)

Seven months, you know, into the year, are we six months worth of production towards that goal, or do we need to re-establish a different goal moving forward to account for missed opportunities? Now I’m gonna say something here, and my team members just know I love you. Doctors, make sure you do this. So if you’re tracking, you’re like, all right, guys, I listened, Nikki, I heard you, and I’m actually ahead on my goal, and I’m ahead by $50,000 this year.

Keep your goal the same. Do not adjust your goal down to meet that other goal. And I know that that sounds kind of obvious, but I want to just state it because there are a lot of people that are like, ⁓ awesome. This month is short, so like it’s okay, we don’t really have to push. Like, no, no, no. Keep pushing and hit for that top tier goal every time so that you have that buffer if it’s ever necessary. Or best case scenario, we end out ahead. Now, the other flip side to that is that.

A lot of times what we’ll see is we might be short by like 20,000 or 10,000, something not like massive. It might not be a whole month’s worth of production, but it might be that like ten to twenty thousand dollar mark. So then what we’re doing is we’re saying, okay, great, this is what we’ve done. This is where we’re gonna go, where we need to be. That gap is now added to the months coming. So if you’ve got ten thousand dollars that you’re short, divide that by the next six months, add that crown cost, by the way.

Add that extra crown into your monthly goal and then reestablish what that will look like. That’s your mid year check-in. So then to Nikki’s point of the case acceptance, I love that, Nikki, because if we know where we’re going, now we can say, okay, how are we gonna get that? Like, how do I get now to 145 instead of that 143 mark? How do I get that extra couple thousand dollars a month? And why was I short to begin with? So what happened there that

Nikki Mack (10:11)

Right.

Tiffanie (10:41)

caused that that mishap and it could have been hours, it could have been days closed, but it could have also been in that case acceptance and diagnosis. So then we start really looking in. So production, collections should match your productions or at least be 98%, right? And then in order to hit those, what does our case acceptance look like? And do we have enough opportunity to hit those goals? And if the opp the opportunity isn’t there, now we’re gonna say, okay, great, why aren’t my new why aren’t I getting enough new patients? Or

Nikki, one of my favorite ones is we have a slew of new patients, sometimes too many, and we’re not diagnosing what we need to diagnose from them. And I’m and I think Nikki this can be misconstrued sometimes because it’s like, well, I diagnose what my patients have. Super cool. I totally agree with you. We are never, ever, ever going to be the consulting company that’s like, no, no, no, there’s more, find it. Maybe there is, but I don’t know. I’m not sitting in your chair and dentistry is, you know, it’s completely objective. So

Nikki Mack (11:16)

Yeah.

Tiffanie (11:39)

I’m not gonna tell you how to dentist. I’m just gonna say, do we have the right opportunities then? So if you’ve got clean patients coming into your practice and you’re hitting new patient numbers, but we’re still not hitting diagnosis, are we reaching the target audience that you need in order to sustain and grow your dental practice? And Nikki, I think that falls into play where we’ve got now

the KPIs, you know, production collections, those are those are hand in hand, case acceptance and then that new patient mark. Are we getting the right new patients? Because to your point, Nikki, in July, if that first six months of new patients didn’t give me the bucket that I needed, I have time now to reevaluate and say, okay, well what does this need to look like? How does my hygiene department need to grow and do my new patients need to shift and change with that? And is that something, Nikki, that you’ve seen like

all over the place. Is that like how how often are you seeing that we just arbitrarily kind of grab the new patients that we can and then miss marks and are like, wait a second, what’s going on?

Nikki Mack (12:42)

Yeah, I think because a lot of times it’s easy to feel like, well, a new patient is a new patient and that’s a win, you know, like we hit 45. But to your point, we have to be intentional, right? And there is a degree of we market, you know, to the audience, right? We hit the keywords, we’re the Google search, we know what we’re looking for. But most of the marketing companies that our offices work with, they say those similar things. Like, what are you trying to bring in?

Tiffanie (12:49)

Yes.

Nikki Mack (13:10)

I had an office, for example, that was changing some of their insurance, you know, contracts. And their emergency ads were bringing in a lot of those insurance-driven patients. So they were having a real struggle with maintaining the schedule they were trying to build with where they were trying to go and who was coming in. And we realized it’s the ads, right? You know, that’s why this number is so high and it’s so hard. So we pivoted, which

Ironically enough, on the flip side, I had another practice just a couple weeks ago. We were having this new patient conversation. They’re focusing on some emergency dentistry targeted ads because they do have a little bit of flexibility. We’ve got a new associate, which is, you know, always great for opening up schedules. And so we realize that we can accommodate some emergencies, right? And ideally be able to take care of those patients the same day, which is just not always the case, right? We’ve we’ve busy practices, we can’t always do it.

So we wanted to capitalize on that opportunity both for the practice, but also what great patient care, right? To consistently be able to see some emergencies, build new patient relationships, and get them taken care of as quickly as possible. It just presents that kind of opportunity. So that to me, actually, funny enough, emergency patients ends up being a really good example of no two offices are the same and no one answer works for everyone. So what could be the like

symptom in one practice is the solution in another. So that’s why it’s super important to take these deep dives and not wait till the end. ⁓ any of my practices or teams that are listening, they hear this all the time, but especially around this time of year, ⁓ we have to sometimes make decisions like we’re a speedboat or sometimes like we’re a cruise ship. And sometimes there’s a quick pivot and it’s an easy fix. And those are some of my favorites as a consultant, right? Those are easy

Tiffanie (15:01)

Yeah.

Nikki Mack (15:02)

Victories, changes, challenges overcomes. Some we’re more like a cruise ship and it’s a bigger strategy and tactics that we need to use to change course. So if we don’t take a look now while we’re halfway through the year, it’s gonna be October, November, and all of a sudden, like we don’t have time to make an impact in twenty twenty six or the year, you know, when you’re listening. So

Tiffanie (15:23)

Totally agree. Yeah. Yeah, whatever yeah.

Nikki Mack (15:27)

You it’s very important to decide what that looks like and that’s how we make decisions. Our numbers tell a story. I know I didn’t invent that, but I do say it a lot ’cause it’s so true. And so we have to read that story and that’s how we make the decisions that are gonna either turn things around for us or keep us on that course to just finish super strong.

Tiffanie (15:47)

Yeah, I agree. Thank you. And I think that July presents a really big opportunity ⁓ for that, for ch making changes. And and previously marketing marketing still is is like a a beast that’s really hard to know. Like you nobody knows marketing. Even marketing companies are like we’re still trying to figure it out. And it’s just like this beta test constantly. So it’s it can be very frustrating in that way, but it’s also really cool because what’s happened now, I know years ago it was like, okay, well, if we’re gonna change marketing.

Nikki Mack (16:04)

Yeah.

Tiffanie (16:16)

It takes six months to even see the product of that marketing switch. But thank goodness we live in a progressive ⁓ future. And we’re here in the future where it doesn’t take weeks, months, you know, six months or so to see that change. Right now we can make a change in the marketing and the online presence and it’s shifting things immediately. And so to your point, Nikki.

A practice that’s like, gosh, we need to fill this doctor’s schedule. Let’s get some emergency patients in that has the right systems that can convert. So that would be, I think if if you’re in July and you’re like, yep, you’re right, guys, I need to shift my marketing focus and I need to look at my new patients. If you’re gonna go the emergence any new patient route, but especially the emergency kind of limited exam new patient route, make sure you’ve got solid systems and that now you’re tracking on top of that our new patient conversion.

rate, right? Because a new patient coming in on a limited exam 0140 in emergency is still a new patient to your practice, but your numbers can get skewed if they’re not staying. Because it’s adding to your active patient count today. But if they don’t come back in 18 months, like it was just a waste, right? So we don’t want to waste your dollars. We want to make sure that’s where Nikki comes in clutch right now with that with that team because she’s not only helping them see, okay, great, let’s shift to this emergency new patient.

kind of standpoint to fill the associate’s schedule, but she’s also helping to train and see how do we track the new patient conversion and what are we saying now? This patient calls as an emergency, cool. How do we get past just a PA? How do we get to that full series of x-rays, the panoramic, the CT, to make sure that we’re looking at everything and fully establishing them as a patient in your practice, not just that emergency. So

Those things go in tandem and this is the perfect time of year to look back and say, these are the things that I wanted. What are the systems that have gotten me to where I’m at? And where do I need to tighten those systems up, maybe shift them a little bit? Or are there systems that I don’t know yet that I’m losing things out the back end? And honestly, your patient base is a huge space for that. Your recare is your hygiene full summers upon us, summers rough in most general practices. ⁓

Nikki Mack (18:31)

Yeah.

Tiffanie (18:35)

I think pediatrics, you guys are you guys are flying high. These are your biggest months. But for GP world, and even oral surgeries flying high right now. But our GP world, our period worlds, those worlds kind of endo ⁓ we see a slowdown and we’ve gotta reestablish what that looks like. So reactivation campaigns are huge right now, but we’re looking at

what were our goals and what is it gonna take for the rest of the year to get us there is gonna be massive. And Nikki, I love that you started us with that case acceptance piece and the new patients because truly this is a great time of year to look at that. And I think everyone thinks it’s kind of like that the diet thing, right? Like I’ll start on Monday. Everybody’s like, well I’ll start in January. Like I have a practice that hats off to them. I love it. They actually redo their fees in July because they’re like, I don’t like

Summers is fine. Like summer’s less busy. We’re doing so much in December, January, February, all the way through to April. Realistically, it’s crazy. So they’re like, why not do it in the summer when it’s slow? I’m like, wow, that’s actually really freaking smart. So to piggyback off of that, like waiting until January to say, let’s change our patient base, let’s change our avatar, let’s

wow, we didn’t quite make it, so let’s add it to this year. And instead of a seven to ten percent increase, we need to do a 12% increase over last year. Like start now, reestablish in July and say, time out, where are we? Where are we trying to go and what’s that gap in between? And then evaluate what are the systems or the processes that I need to change or increase that are gonna get my team there and how do I get that training. Now for your leadership team, they need to be doing that within their departments as well.

So each department should have their own KPIs, which doesn’t have to be hard, you guys, even for our our clinical team. Like it could just be schedule full. It could just be ⁓ diagnosis chair side, right? Or I love nothing more, Nikki, actually on your limited emergency. I love dental assistance tracking. They’re like comp, they’re limited to comp.

conversion. So did they take a 0140 and convert it to 0150 chair side? What is that conversion? So we really don’t have to make it difficult. We just have to make it impactful. It needs to make a direct impact on our overarching goals and it needs to be trackable and measurable. So with that, I think Nikki, what would you say if you could only give we’re going to say production collections is the same because to me there’s there it’s ridiculous you track them both, right? They’re the same.

Nikki Mack (21:10)

Wait.

Tiffanie (21:11)

So if you could only

Nikki Mack (21:11)

Yeah.

Tiffanie (21:12)

give three KPIs knowing production collections is one, what are the other two KPIs that you would insist that everyone takes a look at in July?

Nikki Mack (21:21)

Ooh wee. ⁓ so I am a big clearly you can tell I’m a big fan of new patient reappointment. ⁓ did they come back for six months? Are they scheduled? Did we complete treatment? Right, there’s a few pieces to it, but adding them to the patient base and getting them sticky. ⁓ that would be my number two. And then number three, I don’t know, Tiff. I I kind of feel like I have to go case acceptance because it’s

Tiffanie (21:29)

Yeah.

Yeah.

Nikki Mack (21:48)

It’s pretty all encompassing. there’s so many parts to it, but it just the direction of your case acceptance is such a good indicator of the health of your practice. So those are my those are probably the first three that I look at. If I if I didn’t know anything about your practice, your goals, or where you were headed, those are three places I’m definitely digging in right away.

Tiffanie (21:52)

Yeah.

Awesome. Thank you. I love those. Yes. And I will say in tandem, case acceptance. I like to group things. ⁓ Kiera and I like to say that we get away with a lot because we will group things together. So that’s where my production collections comes in. And I think in tandem with the case acceptance, I say diagnosis because I just really harp on, I think from a team member standpoint of tracking case acceptance for so long and having to

really dig in as a treatment coordinator and as an office manager to figure out why aren’t we hitting these goals and then seeing these trends. So tracking the trends within your diagnosis to lead to your case acceptance is huge. I would have, you know, a doctor gets he’s ready for vacation. He’s worked too hard. He needs a vacation and his case ex or his case acceptance dropped and his diagnosis dropped as well or ⁓ somebody’s killing it. So making sure that we’re watching all of those pieces is huge. So no matter what, you guys, it is mid year and you’re

Nikki Mack (22:52)

Yeah.

Tiffanie (23:05)

well into potentially your Q3 at this point. So I hope you’re listening to this early. ⁓ but really take an assessment and look to see where have I been, where am I going and what’s that gap. And if you’re a few weeks into Q3 already, that’s okay. ⁓ do it before Q4 as well. You need to be doing this literally every quarter, every month, every week, but for sure mid-year. And look at those areas where where

you need a little bit of help. And if you do need help, we’re here for you. You know, we’re we’re right here. We’ve got a freaking thousand podcasts or something that you can listen to. They’re all here, they’re all available to you, but we’re also available at [email protected] and at TheDentalATeam.com, you guys, we have a free assessment call that you can schedule with us where we can take a look at your systems, ⁓ some of your overarching KPIs and really help to direct and guide you and also assess if you are a good fit.

For Dental A Team consulting and if you’re ready for it. And if you if you’re not, ⁓ or if we’re like, you know what, you’re almost ready, you’re you’re not quite there, we will keep in touch and we will still always share all of the information. But we would love to chat with you and really see where you’re at and how we could best serve you in our mission to ⁓ benefit the world of dentistry. So [email protected]. Also, drop us a five star review below. Let us know what your KPIs are. People do read those and they like to look in there for extra.

Help. So Nikki, thank you so much for being here with me today. I know that we pivot and ⁓ that used to be one of our core values. Kiera and I removed it because we’re all really good at pivoting, but we realized that that is a core value made it like we were pivoting too much. But we really do pivot a lot as dental consultants, and it’s something that we’re great at because we’re problem solvers and we do it with our with our clients constantly. So thank you for being here. Thank you for pivoting and having a new Carmen San Diego background.

And you all thank you so much for being here. Thank you for listening and we will catch you next time.

Nikki Mack (24:58)

Bye.