Why you must measure properly when assessing a dentist with a special interest

This article explains the numbers to track, the common mistakes, and how to make better decisions fast.

Most principals have an instinctive sense of whether a clinician is “worth the chair time”. With general dentistry, that instinct is often close enough.

With a dentist who has a special interest, implants, endodontics, ortho, perio, it’s much easier to get it wrong.

The reason is simple: high-value dentistry can look profitable on the surface, while quietly draining margin underneath. If you don’t measure contribution properly, you will either underinvest in a great clinician, or keep subsidising a poor one.

Here’s how to think about it, and how to measure it properly.

The illusion of high production

Special interest clinicians often produce bigger daily totals than general dentists. A couple of implant cases, an endo-heavy day, or a complex restorative plan can inflate production fast.

But production is not profit.

With advanced dentistry, direct costs rise quickly. Lab bills can spike, material usage can be heavier, implant components and surgical guides can be significant, and chair time can be consumed by assessments, reviews, and planning.

So the question is never, “what did they produce?”The question is, “what did the practice keep, after everything it truly costs to deliver that dentistry?”

Start with the right benchmark: what does a surgery day cost you?

Before you analyse a clinician, you need one key number: your operating cost per utilised surgery per day (OCPSPD).

This tells you what it costs the business to run a chair for one day, before a penny of clinical profit is made. It is the fixed cost base that the clinician must comfortably cover, before their sessions become meaningfully profitable.

If you don’t know this figure, you can’t assess session profitability with any confidence. You’re guessing.

The contribution test

Once you know OCPSPD, profitability assessment becomes much clearer.

A sensible way to evaluate a special interest clinician is to calculate their contribution per session:

• gross production for that session

• less clinician pay (percentage split or day rate)

• less direct case costs (lab, implant parts if you carry them, materials assumptions if needed)

• less the OCPSPD for that day or session

If what’s left is thin, inconsistent, or negative, you have a problem, even if the diary looks busy.

And if what’s left is comfortably positive, you can invest with confidence.

This is the difference between running a business and running a diary.

Direct costs are where special interest profitability often leaks

General dentistry has relatively stable direct cost patterns. Special interest dentistry does not.

Two common mistakes:

1. Counting lab and components the wrong way. Some practices deduct lab bills before calculating the clinician’s split. Others pay lab on top. Both can work, but you must be consistent, transparent, and price accordingly.

If you’re paying lab and implant components on top, and your pricing has not been built to protect margin, you can create loss-making “high production” sessions.

2. Pretending materials don’t matter. Materials are harder to allocate to individual clinicians, so many practices ignore them. That’s fine if you use a sensible percentage assumption, but you still need to account for them.

If you omit them entirely, you will overstate profitability, and the error is often worst in special interest work.

Don’t confuse busyness with profitability

Special interest clinicians often require more non-productive time:

• consultations

• planning and scanning

• case presentation and consent

• follow-ups and reviews

• managing complications and adjustments

Those activities are not wrong, they are part of the service.

But if they are not converting into starts, or if the diary is full of “activity” without the right case value, your chair utilisation can look fine while the contribution is poor.

This is why tracking conversion is just as important as tracking production.

The three numbers you should monitor every month

If you want a clean, objective view of whether your special interest clinician is contributing properly, monitor these monthly:

1. Average daily production (or production per session). A useful headline number, but only meaningful when paired with the next two.

2. Direct costs as a percentage of production. Lab, implant parts if applicable, and a materials estimate.

3. Net contribution per session. What’s left after clinician pay, direct costs, and OCPSPD.

If you only measure production, you will make the wrong decision sooner or later.

What to do if the numbers are disappointing

If your analysis shows weak contribution, avoid the temptation to jump straight to blame.

Start with diagnosis:

• Is the pricing structure correct for the way costs are allocated?

• Is conversion being supported properly, for example through TCO triage and pre-qualification?

• Is the clinician spending too much time on low-value work that could be delegated?

• Are you giving them sessions before demand is proven, leading to whitespace?

• Are you carrying costs that should be billed to the patient or built into fees?

Often, the fix is not “get rid of them”. It’s redesigning the workflow and tightening the commercial rules around the service.

The point of measurement is better decisions

A dentist with a special interest can be one of the most valuable assets in your practice.

But only if:

• the service is priced correctly,

• the diary is managed intelligently,

• conversion is supported properly,

• and you measure profitability with discipline.

Otherwise you end up with a clinician who looks impressive, feels busy, and quietly erodes the financial performance of the practice.

If you want to run a practice that grows profitably, stop guessing.

Know your OCPSPD. Measure contribution per session. Then decide what to grow, what to fix, and what to stop.