Why your “Octopussy” is killing profit and how to fight back before Christmas

Chris Barrow
3 hours ago
3 min read

The rising cost of keeping the lights on: your daily surgery costs explained

For many years I have suggested that the “most important number that Dental Practice Owners don’t know” is Operating Cost Per Utilised Surgery Per Day.

OCPUSPD.

My clients are an inventive lot, and one exceptionally bright spark refers to this as her:

OCTOPUSSY

Hopefully, (to avoid blushes or my blog being cancelled) a reference to the infamous "Bond girl" of the book and movie series.

“The commander of an all-female group of acrobats and fighters.”

Well, that is a pretty good description of female Principals in The Extreme Business 100.

And the conversation that is trending in amongst my dental acrobats (and their male colleagues) is how we are observing yet another increase in this number, even before the effects of Budget 2025 flow through.

The history of an average 3 or 4-chair general practice delivering mixed or private dentistry:

· Prior to the 23^rd September 2022 – The Liz Truss Mini-Budget - I would have expected OCTOPUSSY to be around £450 per day per surgery (reminder – fixed costs only, no lab, materials or clinician fees);

· 49 days later Truss resigns but the damage has been done, and continues to the present day;

· Very soon after Truss, I’m seeing OCTOPUSSY start to climb

o 2023 - £550

o 2024 - £650

o 2025 - £750

o Today and in to Q1 of 2026 – I’m looking at clients’ November trading results, January cash flow forecasts and seeing £850 for the first time.

(Sidebar - this is an average - I can see well managed clinics with multiple chairs and 90% utilisation that are still at £450 per day - I can see clinics with fewer chairs and 70% utilisation that are now punching £1,000 per day 😰 - there are one or two who, for various reasons are over £1,250 per day).

Back to the average - the pack.

The impact of the rises I report can be catastrophic to net profit margin, EBITDA (if you are selling) and cash flow (if you are staying).

How do you stop or reverse this process?

1. Put your prices up – client confidence level – 5/10 - "will the patients pay or walk?";

2. Increase individual clinician productivity – client confidence level – 3/10 "I'm struggling to get them to work full time, let alone increase their productivity";

3. Reduce fixed costs – client confidence level – 3/10 - "I can't see where I can make any significant changes";

4. Increase “utilisation” – sessions and patient bums on seats – client confidence level – 6/10 "our marketing isn't working well enough and neither is our recall system";

5. Open more hours and open more chairs – client confidence level – 3/10 - "my team don't want to work longer".

To put it bluntly, there is anxiety involved around any of these options – but doing nothing and watching your profits decline isn’t an option.

So what’s required is action – and now, not after Christmas and New Year.

Every one of those 5 options will bring your OCTOPUSSY down and all 5 are necessary.

I was listening to one of the smartest of my "female acrobats" today, and she shared with me that, in the last three weeks, she has identified over £80,000 of cost savings in her business – that’s simply option 3 above (and, thankfully, didn’t include me).

Hear me when I say – this is a clear and present danger, and you have to act before 19^th December (when some of the world will take their leave, as well as possibly take leave of their senses, for a couple of weeks).

You might want to start by calculating your own OCTOPUSSY this morning - the free download attached will help you to do that.

1. Increase your prices (again);

2. Discuss average daily production target increases with all of your fee-earners (note that I did not include dropping their earnings in the first list – nobody wants a pay cut, period);

3. Review all of your fixed costs vigorously;

4. Get those chairs filled – get the patients and, more importantly, the clinicians in the building;

5. Market like mad and if capacity builds, open for longer.

OCTOPUSSY will continue it's creeping impact if you don’t, and wrestling with an out-of-control octopus isn’t going to be any fun at all.