Endo Mastery


If your practice isn’t growing (or if it is declining), then it’s a huge red flag. Find out the three most common barriers to endodontic practice growth and how to get back on track.

Almost every endodontic practice experiences times when growth slows or stops. It can be frustrating for the doctor when this happens because growth is essential to practice success. If you are not growing, you are effectively declining as increasing expenses and inflation eat away at your profit margin.

Of course, you can increase fees to counteract rising costs (which is something every practice should evaluate at least annually). However, fee increases are not growth. It’s just the illusion of growth due to increased revenues. In terms of completed cases, nothing has changed and productivity is stagnating.

After a few years without meaningful growth, it’s pretty clear the practice has plateaued. That means the practice has reached it’s natural upper limit based on its current systems and strategies. Efforts to grow are being resisted internally and something has to change before growth will resume. Here are the three primary barriers to growth that practices have:

Limited Marketing

Most endodontists learn marketing by trial and error when they first start to practice and have lots of time. After a few years of “hustling” to establish key referral relationships, they settle into the patterns of those relationships, occasionally adding a new referrer to the mix. Marketing often takes a backseat at this point.

At a certain point (and almost certainly when growth plateaus), you need a more disciplined and systematic marketing strategy. That includes a half-time marketing coordinator who prioritizes and nurtures referral relationships with regular meaningful contact.

Inefficient Scheduling

In many practices that have plateaued on growth, the doctor believes they are fairly busy and efficient already if they are completing around 4 cases per day. Given that most endodontic cases, from bur-to-tooth to fill, can be completed in a single visit in less than an hour, a doctor working a 9-hour day is only efficiently using half of their time.

Most often, the doctor is doing tasks during and between patient appointments that could be done by a well-trained team. Aside from a few personal preferences, doctors should only be doing what is legally required for a doctor to do. Once you commit to this and start scheduling doctor time based on what is actually needed, then the schedule opens up for growth.

Ineffective Systems

Even when the doctor is prepared to schedule efficiently, growth can be impeded by what happens before and after patient appointments. For example, patients who arrive late or no-show. Or, a patient who does not agree to treatment immediately after being diagnosed—resulting in idle time for the doctor.

Effective practice systems ensure that patients are appointed efficiently in the doctor’s schedule, that they will show up on time, that they are prepared to accept treatment immediately when diagnosed, and that they are prepared for their co-pay. It also ensures there is efficient communication between the practice and the referring office to support and build the referral relationship.

Getting Back On Track

If growth has been eluding you for a while, it’s likely that you need to “renovate” your dated and aging marketing, scheduling and practice systems. You’ve outgrown the way you’ve been doing things until now. It’s time to take that foundation and optimize it for future growth.

It does require a commitment to restart growth, and expertise to make the right changes that result in growth. You can do this on your own through continuing education and leadership for your team. Another way is through coaching, such as with Endo Mastery, where you benefit from very focused implementation with proven strategies.

Either way, you can’t afford to not grow, because practices that plateau will usually coast into decline over time, and suffer in the long-term.


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