Skip to content
Back to Blog

877: Metric Mondays: What is Your “Production Story”? – Dr. Barrett Straub

You can't unbuild operatories. So, before you start building, there are a few important questions to answer about production. In this episode of Metric Mondays, Kirk Behrendt brings back Dr. Barrett Straub, ACT’s CEO, to break down your production story and explain why you don't need as many patients as you think. Stop the churn-and-burn dentistry that's burning you out! To learn how to rewrite your production story, listen to Episode 877 of The Best Practices Show!

Learn More About Dr. Straub:

Learn More About ACT Dental:

More Helpful Links for a Better Practice & a Better Life:

Episode Resources:

Main Takeaways:

  • There's more to the story than how much you produced.
  • Analyze your annual patient value, active patients, and gross production.
  • Know your production story so you can figure out how to write it going forward.
  • Stop filling production gaps with more patients. Do more dentistry on less patients.
  • Do you want to be a dentist that chases 4,000 patients or have fewer, right patients?

Quotes:

“We talk about leading and lagging indicators, and the ultimate lagging indicator and our least favorite KPI is gross production. So, at the end of 2024, every dentist went and said, ‘Oh, I produced X.’ Let's say it was $1.5 million. You're a solo private practice dentist and you produced $1.5 million. Now, you could theoretically have two practices that produced the same gross production, but how they got there could be vastly different. So, just because we produced a number, there's more to the story. What your production story is going to tell you is how you got to your gross production.” (1:49—2:31) -Dr. Straub

“Let me introduce a couple things. One is annual patient value, another is active patients, and then, obviously, gross production. Annual patient value is this magic KPI that basically takes your revenue and divides it by the number of active patients. That is such a valuable tool. Let me pose it two different ways. There are two spectrums of the business model. If you've been listening to this Metric Monday story, if you've been attending our study club meetings in Milwaukee, you hear us talk about the business model spectrum. On one end, we have high volume, low profit margin. Those two often go hand in hand, and we explain why. On the other side of the spectrum, you have low volume, high profit margin. So, what I'm getting at here is two different practices can reach $1.5 million of gross production in two different ways. One is going to do a lot of dentistry on a small number of patients. So, low volume, a smaller number of patients, high profit margin. Meaning, highly profitable dentistry, comprehensive dentistry. They're going to do, per patient, a lot of dentistry. The other end of the spectrum is high volume. So, a lot of patients, and we're going to do a little bit of dentistry. So, a little bit of dentistry, one to two-tooth dentistry on a lot of patients, and we can get to $1.5 million.” (2:32—4:11) -Dr. Straub

“If we know a practice's number of active patients and their gross production and their annual patient value, we can pretty much analyze a practice and say, ‘I know what your days look like. I know if you're writing off a lot or a little. I know where on that spectrum you sit.’ Most sit somewhere between those two extremes. And why this is important is not for us as dentists to say, ‘I did $1.5 million.’ That's great. That's important. That's the first step. Now, what did that feel like? What did that do to my life? How is my team culture working — the model I'm working — and is that what I want? A lot of our clients find themselves in a business model they didn't want, and they didn't strategically identify as being their goal. They kind of got there by happenstance, by accident. And there are lots of different ways we do that. So, what the production story says is when you're burned out, when you're too busy, or not busy enough, we can start to dig in beyond gross production, beyond active patients, and say, what is my production story now and how do I want to write that story going forward?” (4:29—5:46) -Dr. Straub

“When your APV is low, you need a lot of [patients]. So, this is the point in the podcast where you have to decide as a dentist — you've got to put your flag in the ground and go, ‘This is the kind of dentist I want to be.’ Do you want to be chasing 4,100 patients, or do you say to yourself, ‘Listen, I want to do 1,500 patients. I want to find the right type of people,’ full well knowing I've got to replace 17% of my patient base every year. These people are going to refer more of the same type of people. And you have to do that now — because if you don't, your practice will be flooded, intentionally, by the insurance companies with what you didn't want, and now you're going to be reverse engineering this.” (6:04—6:46) -Kirk

“The worst business model is low volume, low profit margin. Those are start-ups or businesses about to go out of business. So, the reason that we have high volume — lots of patients with a low profit margin — is exactly what I'm talking about. I need to produce. I'm producing a little bit on each patient, and instead of raising the per-patient amount of dentistry we do, I'm just going to get a bunch of patients. So, think of the big churn-and-burn practices where they're booking out years and months, and doing a little bit of dentistry, and they're seeing a ton of patients. ‘I got 72 new patients this month.’ I'm just churning through. Most people don't want to work at that pace. The reason they do is it's a simple numbers game. If I see less patients, I'm going to produce less. But if we're smart enough, we can say, ‘If I do more per patient, if I raise my APV, if I raise my production per day, production per hour, production per visit, if I collect more money per active patient, guess what? I don't need as many patients.’” (7:28—8:44) -Dr. Straub

“We can produce more. How do you produce more? You either see more patients or do more dentistry per patient. It's up to us to find that balance. And unfortunately, most people fill any gap in production simply with more, more, more numbers, more volume, volume, volume, volume versus sitting back and analyzing, how do I do a higher level of care? How do I do a little bit more comprehensive dentistry on my 1,300 patients that I have?’ Why get 1,800 or 1,900 patients per full-time dentist if you could do the same amount of production or more and be more profitable doing it in 1,300?” (8:53—9:35) -Dr. Straub

“This could be a four-hour podcast on differentiation and skills and all that, but it's simple math if we just think of, how much do I want to produce? How many patients do I have? Therefore, how much revenue do I have to collect per those 1,500 patients and be able to do it? You can also reverse it and say, ‘Boy, I'd really love to raise my gross production.’ Great. Raise it by 20%. Is that even possible? Well, I have 1,500 patients, and my annual patient value is currently this. Does that math even work? When it doesn't, you're going to say, ‘Well, I've got two options. I can get a bunch more new patients and actually work faster, more volume, volume, volume, volume, or I can say, what if I did a little more on those same 1,500 patients?’ Now, my gross production goes up, and I'm still only working my same eight hours, and I'm working a little less within those hours.” (9:42—10:36) -Dr. Straub

“Whatever your production story is, learn your story. It doesn't have to be perfect. Like, you might be listening to this going, ‘Okay, I've got 2,100 patients, and my APV isn't that high.’ If you improve your story and you start learning about the story, you're going to be amazed by how much better your practice is month over month, quarter over quarter. You don't need to go to perfect, and you don't need to get out of network. You’ve just got to improve that story month over month.” (11:19—11:43) -Kirk

“What happens when you have 1,923 active patients per dentist, you can't take many vacations. Because how many times have we heard this, like, ‘I have to see all these people! I have to serve all these people! They're booked out seven, eight, nine months in hygiene. I can't take a vacation.’ Then the next step is, what? ‘Well, I've got to hire someone to help me see all these people.’ Now, we're further. Now, we're locked in the concrete of this high volume practice that — if you want that, go for it. Go nuts. But you can see how this happens without us knowing it. And before too long, it's like, ‘I've got two practices, seven associates, my life is miserable, and I don't want this. I want to go be a comprehensive dentist.’ Now, the time to make that call was about five years, three practices, and six associates ago. So, I want us to think about this production story and then match it to what you thought or want your story to say, and then say, ‘How far apart am I?’ Then, with our help and our advice, we can start saying, ‘Okay, if you want to move to that side of the spectrum, here are some of the things you can do and some strategies.’” (14:21—15:40) -Dr. Straub

Snippets:

0:00 Introduction.

1:23 Why we need a production story.

2:32 Important KPIs you need to know.

6:46 Do more per active patient.

11:47 Countermeasures you can start today.

Dr. Barrett Straub Bio:

Dr. Barrett Straub practices general and sedation dentistry in Port Washington, Wisconsin. He has worked hard to develop his practice into a top-performing, fee-for-service practice that focuses on improving the lives of patients through dentistry.

A graduate of Marquette Dental School, Dr. Straub’s advanced training and CE includes work at the Spear Institute, LVI, DOCS, and as a member of the Milwaukee Study Club. He is a past member of the Wisconsin Dental Association Board of Trustees and was awarded the Marquette Dental School 2017 Young Alumnus of the Year. As a former ACT coaching client that experienced first-hand the transformation that coaching can provide, he is passionate about helping other dentists create the practice they’ve always wanted.

Dr. Straub loves to hunt, golf, and spend winter on the ice, curling. He is married to Katie, with two daughters, Abby and Elizabeth.
ACT Dental Team

ACT Dental Team

    Subscribe to our newsletter