1018: Metric Mondays: If the Numbers Look Good, Why Does the Practice Still Feel Heavy? - Ariel Siegel

Do your numbers look good on paper, but the practice still feels heavy day-to-day? In this episode, Kirk Behrendt brings back ACT coach Ariel Siegel to explain why “busy” doesn’t automatically mean “healthy,” and how the effort gap between gross production and net production creates exhaustion, tight cash flow, and a constant hamster-wheel feeling. You’ll learn how to calculate your effort gap, translate it into an “energy quotient,” and start managing write-offs so your schedule is built around profitable dentistry—not just busy dentistry.

Listen to Episode 1018 of The Best Practices Show!

Main Takeaways:

1. Gross production can look successful while net production reveals whether the practice is actually healthy.
2. The “effort gap” is the difference between what you produce and what you will realistically collect after adjustments and write-offs.
3. When the effort gap is high, the team isn’t lacking effort—it’s performing dentistry that won’t be collected, which creates the feeling of heaviness.
4. You don’t get paid on gross production, but you still pay overhead on gross production, which makes the gap more damaging as the practice grows.
5. Converting the effort gap into “days worked for free” helps quantify how much time and energy is being donated to adjustments.
6. Tracking both gross and net production allows you to see the effort being spent and the money actually retained, so you can make informed decisions.
7. Breaking adjustments into categories (membership, elective discounts, and insurance by plan) creates transparency and shows exactly where to start improving.

Snippets:

00:00 Intro

01:15 Why “numbers look good” can still feel heavy.

02:15 The effort gap: gross production vs. net production.

03:15 Why gross production is a false proxy in today’s dentistry.

04:20 You don’t get paid on gross production, but you pay out on it.

07:05 Bigger isn’t always better: adjusted EBITDA and what a large practice is really worth.

08:10 Turning the effort gap into an “energy quotient.”

10:55 Track both gross and net production to manage effort and collections.

12:10 How to calculate your effort gap using the last 12 months.

13:20 Break adjustments into categories to find the biggest drivers.

15:00 Clean reporting: track insurance adjustments by plan, not one bucket.

16:40 The first step is finding where the heaviness is coming from.

Guest Bio/Guest Resources:

Ariel has a master’s in healthcare administration and several years of dental experience in all aspects of the administrative roles within the dental office. Her passion is to work with dental teams to empower team members to realize their full potential in order to better serve patients, improve office systems to ensure a well-functioning team/office, and to help everyone have fun in the process!

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

1. The Best Practices Show: https://www.actdental.com/podcast/
2. Best Practices Association: https://www.actdental.com/bpa
3. Upcoming Events & Workshops: https://www.actdental.com/events/
4. Smile Source: https://www.smilesource.com/
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