DDx — SPECIALTY DENTAL
Specialty Dental: the five ways this presents
Each presentation below lists what could be causing it, ranked, with the finding that tells the causes apart and what resolution actually looks like. 25 causes, 25 tests, each cited to a primary source for this specialty rather than borrowed from another one.
Nothing on these pages describes a client or an engagement.
PRESENTATIONS
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Patient acquisition cost is climbing
"We are paying more for every start than we were two years ago." Or, in the referral specialties: "I have no idea what a referral costs me and neither does anyone who has ever pitched me." The spend line moved, the starts line did not, and the number the pract…
5 CAUSES · 5 TESTS
WORK IT THROUGH → -
New patient volume is short of plan
"The referrals come in, the front desk logs them, and a third of them never sit in the chair." In orthodontics the same complaint sounds different: consultations are up and case starts are flat. In endo, OMS and perio the practice can usually name its top five…
5 CAUSES · 5 TESTS
WORK IT THROUGH → -
Growth has plateaued
Starts are flat three years running, or the referred-case count has not moved while the practice added chair time and a second assistant. The owner is not in crisis — collections are fine — but the line has gone horizontal and nobody in the practice can say wh…
5 CAUSES · 5 TESTS
WORK IT THROUGH → -
Performance varies by location
A group with three to twelve locations, one fee schedule, one set of scripts, and one office running at capacity while another sits half-empty. The owner has already tried moving the marketing budget toward the weak site and it did not move. The suspicion is t…
5 CAUSES · 5 TESTS
WORK IT THROUGH → -
Preparing for sale
An owner twelve to thirty-six months from a transition, with good numbers and a nagging question: what happens to the case volume when I stop taking the referring doctors to lunch. A buyer will ask exactly that, in exactly those terms, and the answer is usuall…
5 CAUSES · 5 TESTS
WORK IT THROUGH →
WHICH ONE
How to tell which one you have
These five overlap, and two or three usually apply at once. The order to read them in is set by which number actually moved. If cost per new patient moved, start there. If demand held and bookings did not, start with the volume page. If nothing moved at all, start with the plateau page — and if the group total looks acceptable while one site keeps coming up in conversation, read the variance page first, because a pooled number is structurally incapable of showing you what you are looking for.
Every cause on every page above carries a measurement you can run in your own systems, with the finding that confirms it and the finding that rules it out. Run two or three before you brief anybody. If the tests tell you this is not a marketing problem, that is the correct answer and it cost you nothing.
RESOLUTION
What resolves each, and what resolved looks like
Each presentation resolves to a different part of the work, and the pages say which: reporting and attribution where the finding is a measurement error, conversion and desk work where the loss is between the inquiry and the admission, acquisition where the demand genuinely is not there, and pre-sale work where the question is whether growth can be re-run by somebody else.
Each also carries what resolved looks like as a number — the measure, the published median, the top decile where an honest one exists, and a target range — with the source in the row. Where no credible distribution is published, the page says so instead of borrowing one from an adjacent specialty. That absence is itself a finding: it means your own trailing history is the only benchmark worth measuring against.
WHERE YOU STAND
Reference ranges for specialty dental groups
See also where you stand and what decides the outcome before any of this is treated.
A differential narrows the list. It does not close it — that is what the examination is for.
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