Ask most endodontists about overhead and they will give you a percentage. It is a useful number, but it can also hide a lot.

When collections rise, overhead percentage falls even if spending has quietly grown. When collections dip, it rises even if nothing about your costs has changed. On its own, the percentage does not tell you whether your practice is becoming more efficient.

That is why the coaches at Endo Mastery also look at a simpler measure: what it costs your practice to complete each case.

• Why overhead percentage alone can be misleading

• How to calculate your cost per case in about ten minutes

• Why endodontic practices have unusual leverage on cost per case

• Where to look first for savings

• Step 1: Add up last month's total operating expenses. Exclude the doctor's own compensation and loan principal.

• Step 2: Count the cases you completed that month.

• Step 3: Divide total expenses by completed cases.

That is your cost per case. Track it every quarter. The trend matters more than any single month.

Most of the costs in an endodontic practice are fixed: rent, salaries, equipment, software, and insurance. They stay roughly the same whether you complete three cases a day or six. Variable costs, the supplies and fees that rise with each case, typically run under 10% of revenue.

That means every additional case spreads your fixed costs across more treatment, and your cost per case drops.

Here is an illustration. Suppose a practice spends $55,000 a month on operating expenses and completes 68 cases, about four per day over 17 clinical days. Its cost per case is roughly $809. Now add one case per day. With variable costs of about $140 per case, monthly expenses rise to about $57,400, but the practice completes 85 cases. Cost per case falls to about $675, and monthly profit rises by more than $21,000.

• Completed cases per day. More cases on the same fixed base is the biggest lever.

• Delegation. When the doctor performs only what requires the doctor, the same team completes more treatment.

• Scheduling. Open doctor time is a fixed cost with nothing to show for it.

• Same-day treatment. A consult that becomes treatment the same day uses the time you already reserved.

Growth is the biggest lever, but spending still matters. Review these areas every quarter:

• Software and subscriptions that no one uses anymore

• Supply ordering without a clear par level, leading to duplicates and waste

• Overtime that comes from scheduling gaps rather than true demand

• Technology purchases that were never fully adopted by the team

Cutting costs can only take a practice so far. The practices with the lowest cost per case are rarely the ones that spend the least. They are the ones that complete the most treatment on a well-managed cost base.

TRY THIS THIS WEEK
Calculate last month's cost per case using the three steps above. Then calculate it for the same month last year. Which direction is it moving?

• Overhead percentage alone can hide whether your practice is becoming more efficient

• Cost per case = monthly operating expenses ÷ completed cases

• Most endodontic costs are fixed, so every added case lowers cost per case

• Delegation, scheduling, and same-day treatment are the biggest levers

• Review subscriptions, supplies, overtime, and unused technology quarterly

• The Phenomenon of Hard Costs

• Creating Momentum in Doctor Productivity

• The Q4 Numbers Top Endo Practices Watch

Download the free Cost Per Case Worksheet: a step-by-step calculation, a one-more-case-per-day scenario, and a quarterly tracker.

If your numbers raise questions, a Discovery Call is a helpful next step. No obligation. No pressure. We promise.