What we find
We do not take aggregate reports at face value, and neither should you.
One patient, one tooth, two plans: extraction, root canal and crown on one; extraction and implant on the other. Nobody knew which until the dentist was in there trying to save it. The treatment was completed. The other plan was never cleaned up. Your unscheduled treatment report now says there is a $5,000 call to make. There is no call.
Multiply that by every tooth in the practice and the report you manage from is wrong by a number nobody has measured. We rebuild the report from the detail, decode how your team actually uses the software, and then the number is real. Every finding on this page is built that way.
The Retention Sheet
One multi-location group. 7,544 new patient charts created in twelve months.
Three checkouts, read from the codes and the schedule, not from anyone's account of what happened.
| Checkout | Patients | Progress | PDA standard | At standard |
|---|---|---|---|---|
| New patient charts created | 7,544 | 7,544 | ||
| Showed up for a first visit | 5,294 | 70% | 75% | 5,658 |
| Came back for any second visit | 2,924 | 55% | 75% | 4,244 |
| Left with a next appointment on the books | 1,412 | 48% | 80% | 3,395 |
| Retained, end to end | 1,412 | 18.7% | 45% | 3,395 |
- 1
Chart created to first visit.
2,250 charts never sat in a chair, and $559,000 of marketing bought them. The appointment was too far out, nobody recovered the no-show inside 48 hours, or the front desk created charts for callers who never booked. Each is a different missing system, and the data says which before anyone is trained on anything.
- 2
First visit to any second visit.
45 of every 100 patients who sat in the chair never came back for anything, not even a cleaning. Underneath that number: emergency patients who left without a comprehensive exam on the schedule, treatment diagnosed and never put on the books before the patient reached the door, and exams with nothing diagnosed at all.
- 3
Second visit to a next appointment on the books.
52 of every 100 patients who finished left without one. That is the checkout, not the clinic. It is the same failure as this group's 71% hygiene reappointment rate against a 90% standard, measured on a different cohort.
The order of work
| Fix one checkout, hold the other two | Patients kept | Year-one production |
|---|---|---|
| Chart created to first visit, to 75% | +97 | $117,000 |
| First visit to second visit, to 75% | +505 | $607,000 |
| Second visit to next appointment, to 80% | +927 | $1,110,000 |
| All three, to standard | +1,983 | $2,383,000 |
The last checkout first. It costs nothing, needs no marketing and no clinical change, and it is worth $1.11 million.
The money rows
- •The group spent $1.88 million to create 7,544 charts: $249 each.
- •Cost per patient kept: $1,328. At the standard, on the same spend: $553.
- •Each kept patient produces $1,202 in year one and about $786 a year after that. Net of the cost of serving them, $721 in year one. Payback on the acquisition cost: 22 months at today's retention, 9 months at the standard, on the same marketing budget.
- •The 1,983 patients lost in year one keep leaving, at the group's own 71% reappointment rate:
| Year 1 | Year 2 | Year 3 | Year 4 | Year 5 | Five years |
|---|---|---|---|---|---|
| $2,383,000 | $1,112,000 | $793,000 | $566,000 | $403,000 | $5,257,000 |
Five years, one cohort: $5.26 million. Once five cohorts overlap, that is the gap the group runs at every year.
Your size
The same sheet at your volume.
A practice creating 300 new patients a year at these rates leaks $95,000 in year one and runs $209,000 a year under its own standard once the cohorts stack. At 480 a year, $152,000 and $334,000.
Per new patient created: $316 in year one, $697 at steady state. Your practice at this group's rates and values; your own numbers come from the Baseline.
- Patients short of the standard
- 79
- Year one
- $95,000
- Every year, once the cohorts stack
- $209,000
Static page math. Nothing is submitted or stored.
The roadmap
The Retention Sheet is one row.
The Baseline runs the same method on every cohort in the practice and ranks the rows by dollars per unit of effort. Each row is tagged: a system that does not exist, or a moment that is trainable. Each row has an owner.
- 01
New patient retention
The three checkouts above.
- 02
Hygiene reappointment by column
90% standard; about 78% observed average; one $10 million practice at 61% same-day. Which hygienist's column reappoints and which does not.
- 03
Broken appointments by day and time
The holes are predictable, so the broken slots become the emergency and same-day blocks. Priced at broken hours times hourly production, plus the emergency patients who convert to a comprehensive exam.
- 04
Case acceptance by procedure group and by dollar band
$0 to $1,000, $1,000 to $3,000, $3,000 to $5,000, $5,000 to $10,000, $10,000 and up; by exam type. A small-dollar band that does not convert is a scheduling system missing, not a money problem.
- 05
Periodic exams by hygienist schedule
Which columns the doctor's exam reaches and which it does not.
- 06
Unscheduled treatment, scrubbed at the code level
In one $1.3 million practice the buyer's advisor flagged $1.19 million of unscheduled treatment as inaccurate and never scrubbed it. The scrub is the number.
- 07
Custom codes
In one $10 million practice, $1.5 million of production sat under practice-created codes that never entered the claims process.
- 08
Credit balances and refunds
The same practice: $390,000 of refunds in the software, $150,000 on the P&L.
- 09
Diagnostic concentration
The same practice: 24.6% of all diagnosis on 4.4% of exams, one chair. The $1.3 million practice: 61% of production in the owner's hands.
- 10
Coding exposure by provider
The same $10 million practice: $680,000 across six code families, every claim clean and paid, under an insurance collection rate of 107% of net insurance production.
- 11
What comes off your number
Owner compensation at market, related-party rent, 1099 contractors doing W-2 work ($155,000 in that practice). Reported $720,000, normalized $595,000. Read →
- 12
Fee schedule against UCR, by payer
What each payer pays against what the market charges, code by code.
- 13
New patients by source
Cost per kept patient by channel, the only marketing return that exists.
How a row becomes a dollar
Standard, observed average, this practice.
The units short, times the value of a unit. Year one, then five years, decayed at the practice's own reappointment rate rather than ours, so the number is conservative by construction.
No projections, no "potential." The dollars are what the practice already paid for and did not keep.
Who reads it
Same sheet. Four readers.
- OWNERreads the order of work.
- RMreads the columns, ranked, and cost per kept patient by channel.
- BUYERreads whether the revenue is recurring or bought: a practice that spends $1.88 million a year to keep 19 of every 100 patients is growing on paper and standing still in fact.
- LENDERreads the same rows as the durability of the earnings it just sized the loan on.
The first read
Send one report.
Production by procedure code, last twelve months. No patient names. One page and a call in 48 hours. $495, credited in full to the Baseline.