How to Thrive with Fewer Days doing Chairside Dentistry

Intro: This is The Thriving Dentist Show with Gary Takacs, where we help you develop your ideal dental practice, one that provides personal, professional, and financial satisfaction.

Gary Takacs: Welcome to another episode of The Thriving Dentist Show. I’m Gary Takacs, your podcast co-host. We have an exciting podcast episode for you today. It’s titled How to Thrive With Fewer Days Doing Clinical Dentistry, How to Thrive With Fewer Days Doing Clinical Dentistry. Now, that title may sound counterintuitive to you; however, by the time we finish this episode, you’re gonna have some great strategies on how to actually reduce your clinical time and still have a thriving, growing practice.

Well, before we get into that podcast episode, a couple of announcements to make. Coming up, I wanna announce our next event, Thriving Dentist event. It’s coming up on January 27th. It starts at 7:00 PM Eastern Time. It’s a one-hour panel discussion, and this panel discussion is gonna be titled Kickstart 2026. So everybody that’s gonna participate in that panel is gonna have wisdom and advice and counsel on how to make 2026 your best year yet.

You’ll get one hour of CE, and there is no tuition. Any of the events that we do, we do as no tuition as a courtesy for your listenership. You do need to register. If you’d like to register for that event, go to thrivingdentist.com/events , and you’ll see that particular panel discussion, and you’ll need to register, grab a seat, but you’ll get an hour of CE credit. More importantly, you’ll get lots of useful information you can use to make sure 2026 is your best year yet.

The second announcement I have is we have a returning guest, an international dentist, Dr. Omar Montaser, and his clinical tip is the key to successful root canal cleaning lies in the isthmus. So I think you’ll appreciate his wisdom regarding root canal therapy. No further ado, here’s our international guest, Dr. Omar Montaser.

Dr. Omar Montaser: Hello, everyone. This is Dr. Omar Montaser. I’m glad to be invited once more to be on the Thriving Dentist Podcast. Here’s a quick critical tip for you all. We have two canals. This is a lower first molar. You have the mesiobuccal and the mesial canal, but of course, in this magnified view, you can clearly see you have a corridor, a channel between them. This is called the isthmus. The isthmus is the part connecting two canals in the same root.

This part—we cannot really clean it with files. We cannot shape it with files. The only way to disinfect it and properly clean it is proper irrigation, because this area can harbor bacteria, microorganisms that can cause failure in the future. So to ensure you properly clean it, you should use proper activation of the irrigation, either sonic or ultrasonic.

Of course, if you have a curved root, it’s more advisable to use the sonic tips because they are more flexible. They can go inside the curves. If you have a straight root, you can use either ultrasonic or sonic.

So don’t forget to activate your irrigation, especially in roots with a high frequency of isthmus present, which are the mesial roots of lower molars, the mesial roots of upper molars between the MB1 and MB2. You can have a large isthmus, and sometimes you have an isthmus between the distobuccal and the palatal. I know it’s not so common, but you can have something like that harboring tissues and maybe harboring canals.

When I properly clean this isthmus, I will check properly because I might find a hidden middle mesial canal inside this isthmus. So take care to activate irrigation, and see you later.

Naren Arulrajah: Welcome back to the Thriving Dentist conversation that I’m gonna have today with Gary. And the topic we are gonna be covering is a really important topic, and it’s a topic I think that’s timely. This episode is being published literally the day before Christmas, so Merry Christmas to all of you. And as you reflect and take some time to breathe and appreciate the good things in life, I’m sure you’re thinking about 2026. And the topic today is how to thrive with fewer days doing chairside dentistry. It’s an interesting question, right? You have been perhaps practicing for two years, five years, 10 years, 15 years, and most of you probably kept doing what you did the prior year the next year. Perhaps this time is different. Perhaps you could consider: how can you do better without having to do as many chairside dentistry days?

Of course, we all get older. I know this conversation might be even more valuable to those of us perhaps in our forties and fifties, because I bet we are all thinking about maintaining our quality of life and maintaining the quality of care that we are able to provide to our patients, but perhaps with fewer days. So, Gary, take it away, and let’s have a meaningful conversation. Any quick comments before I jump into this, Gary?

Gary Takacs: No, I think this is one of the most important topics we’ll discuss on the podcast. It really has to do with how do you engineer a practice so that you have an effective work-life balance? And let’s face it, dentistry is a rigorous profession physically. It’s rigorous, right? There’s a lot of occupational hazards that go with doing dentistry. These are some of the things that are less talked about in the career, but yeah, you know, there’s a lot of issues. There’s back issues, shoulder issues, joint issues, eyesight issues, hearing issues. And I think if you want to enjoy a long career by choice, you can’t take care of others until you take care of yourself.

Naren Arulrajah: Thank you, Gary.

Gary Takacs: Can’t give from an empty wagon.

Naren Arulrajah: Absolutely. I agree with the key word that came out of your comments, which is work-life balance, right? And I think you and I have probably heard dozens and dozens of stories of friends of ours whose work was affected because they didn’t practice work-life balance when they were younger, and they worked too much, and they just injured themselves. I mean literally injured themselves.

Gary Takacs: Yeah.

Naren Arulrajah: Let me start with the big question. Is it even possible to have a thriving practice and effective work-life balance, Gary?

Gary Takacs: Yes. And notice I answered that without hesitation, Naren. And the reason I can answer that without hesitation is it’s one of the cornerstones of our work in our consulting to help our clients achieve an effective work-life balance. And under that axiom—you’ve heard this before, Naren—if it’s been done before, it must be possible, right? So this has been done. This is Roger Bannister breaking the four-minute mile. Remember when Roger Bannister in 1954 broke the four-minute mile? It was deemed not possible. There were sports physiologists that said a human being could not run a mile in less than four minutes. And yet in May of 1954, he ran it in three minutes, 59 seconds and change—under four minutes. And up until then, no human being had ever done that. However, within three months, three other people broke the four-minute mile. So did physiology change in that three-month period of time? No. What changed?

Naren Arulrajah: Mindset. Like what is possible, what people thought could be done. And if you believe something can be done, absolutely it can be done.

Gary Takacs: Yeah. And fast forward to today. Today, many years later—71 years later—there are world-class high school athletes that run under four-minute miles. And again, physiology hasn’t changed that much. When we measure this in scientific time, 70 years is nothing, right? But now we have high school athletes—world-class high school athletes—that are running in under four minutes. So yeah, I can confidently say to have a world-class practice and an effective work-life balance, it is absolutely possible because we do it every day in our work, in my coaching work. So yes, yes, it can be done. It’s not easy. I don’t want to sugarcoat it and say, oh, this is easy. It’s not easy. But it absolutely can be done.

Naren Arulrajah: Thank you, Gary. Where should our listeners start if they are serious about reducing their clinical days chairside and yet have a growing practice, meaning they’re doing better the next year versus the year prior?

Gary Takacs: Well, Naren, you know, our listeners may not know this, but I enjoy math. And you actually start with math. Let me take a minute and explain this. You start with math, right?

Early in my career, early in my coaching career, there was a common issue that a lot of dentists wanted to solve. And the issue was, “Gary, I’m working five days a week, and I’m really feeling burned out. I want to get to a four-day clinical week.” Because they would say, “Well, I’m working five days a week clinically,” and back then it was kind of common for doctors to work Monday through Friday, right? But if you’re the owner of the practice, if you’re working clinically Monday through Friday, your work’s not done, is it?

Naren Arulrajah: No. You are doing payroll, you are hiring people, you’re dealing with payments, all kinds of other things you pay attention to.

Gary Takacs: So now, if you’re doing that Monday through Friday back then, where does that other stuff get done then?

Naren Arulrajah: Uh, evenings, weekends.

Gary Takacs: Saturdays, Sundays, you know, you get started. And so a lot of them said, “Well, I want to at least have a weekend with my family. I want to go to four days a week.” And I said, “Well, that’s a math problem. That’s a math solution. Let’s figure out what you’re producing five days a week and figure out how we can do it in 20% less time.” Twenty percent. So if you’re working five and you go to four, that’s a reduction in your clinical days of 20%. Am I doing the math right, Naren?

Naren Arulrajah: Yes. Yes.

Gary Takacs: So all we have to do is do the math equation—figure out what you used to produce on five days a week and figure out how to do it in four days a week, right? So now we have a math equation, now we have a new target, and then we simply design a scheduling template that’s gonna allow you to produce 20% more in four days compared to five days. Easier said than done.

Naren Arulrajah: I think, just a tiny correction, Gary, I think you’re doing 25% more, because each day you’re doing 25% more, and that makes up that extra day.

Gary Takacs: There you go. You’re right. You’re right. Your math is better than mine. It’s a 25% improvement, yes. But by doing that, you now engineer a day. One of the things we teach in our coaching is that the schedule can be engineered. You can engineer ideal days. In most practices nothing remotely like that ever occurred. It’s just scheduling team members putting names in the schedule. There’s just names. There’s an opening, you put in a name. There’s an opening, you put in a name.

Instead, you can engineer it. And you can engineer that so some of the things that need to be done is we need to get an awareness of what you’re historically producing per hour, producing per… this is where it gets a little bit granular with the math.

Gary Takacs: Figure out what you’re historically producing per hour. And, you know, if you’re working on constant improvement, that’s a number that should be improving over time. And you can improve it through a number of things—through clinical efficiency. I’ll name three things you can do to improve your production per hour.

Becoming more efficient doing a service. And doctor, if you’re questioning me—“Is that even possible?”—reflect back to your D3 year in dental school. Reflect. I’ve got everyone reflecting back. Remember the first crown prep you did in D3? Remember how long that took? And you’re now thinking, “Oh my gosh, that poor patient.”

Naren Arulrajah: Like double or triple the time that you probably take now, right?

Gary Takacs: I won’t plug you—I won’t use any names, of course—but I’ve had doctors tell me, “Oh my goodness, my first crown prep in dental school took this long.” Right? And reflect on what it is today. So clinical efficiency is one thing.

Secondly is greater delegation to our team members or assistants. I encourage you doctors to allow your assistants to do everything they’re allowed to do under your state practice act. There’s a state dental practice act. Don’t cross over the line—do not cross over the line—allowing them to do things they’re not allowed to do. That’s not good. But allow them to do whatever they’re able to do under your practice act, provided it can be done to your standard of care.

So, for example, if you have a new assistant, and in your state the assistant can make temporaries under your practice act, then allow your assistant to make temporaries provided the temporary is made to your standard of care. If we’re temporizing, make sure it can be done to your standard of care.

Many dentists have never really given a thought to developing their assistants—developing their assistants’ full potential. And that applies to all kinds of things, especially digital dentistry today. So many things our team members can do digitally for us that weren’t possible in the analog days. And a lot of times our team members can be younger; they can adapt to technology a lot better. And they need training.

So tip number two is allow your assistants to do everything they’re allowed to do. And tip number three is change your mix of services so the things that are more productive, you do more of that. More of that. So another way to say that is: add high-value services.

Gary Takacs: Add things like placing and restoring implants, adult orthodontics like Invisalign, cosmetic dentistry like smile design cases, complex restorative dentistry, maybe diagnosing and treating sleep apnea with appliance therapy. And so through the combination of the blend of those three things—greater clinical efficiency, greater delegation with our team members, and number three, a better mix of services that allow you to be more productive per unit of time…

Naren, I’ll ask you, I’ll put you on the spot. As a clinical service, think of the different things that are done clinically. There is hard data on this. What procedure clinically do you think is the most productive service, or certainly one of the most productive services? What would you guess?

Naren Arulrajah: Fillings? I mean, when you say productive, meaning in terms of revenue? In terms of how much you can get? Revenue.

Gary Takacs: Revenue.

Naren Arulrajah: Oh, yeah. In terms of revenue, I would say veneers—any of those smile makeover cases.

Gary Takacs: It’s actually two things: placing implants—placing straight implants—and, if you do third molar extraction, third molar extraction. So they’re both surgical.

Naren Arulrajah: Implants. Oh, interesting. So you don’t think smile makeovers are that productive from a financial standpoint?

Gary Takacs: By the time you measure the time—because there’s a lot of different steps that go there—yes, they’re highly productive, a lot more productive than typical general dentistry.

Naren Arulrajah: Right, right, right.

Gary Takacs: But not as productive per unit of time. Think about wisdom teeth extractions. Again, I’m not suggesting everybody should do wisdom teeth. Certainly.

Naren Arulrajah: Some doctors are not big fans of it.

Gary Takacs: That’s okay. That’s why you have an oral surgeon that you refer to. But wisdom teeth and placing and restoring implants make sense. And—but—all of the high-value services, veneer cases would be in that category.

Naren Arulrajah: Even like sedation dentistry, right? Usually you do have a lot of it going on at the same time.

Gary Takacs: You do a ton of it. Because usually the reason we’re doing sedation dentistry is the patient hasn’t been to the dentist in 20 years. Why didn’t they go to the dentist for 20 years?

Naren Arulrajah: They’re afraid of the dentist.

Gary Takacs: Now we have sedation. And now you’re very productive per unit of time doing sedation dentistry. So we need to kind of know ourselves. We need to know what services you like to do. And if there’s maybe something—maybe you would like to aspire to place and restore implants, but you don’t feel that your skill set is there yet—so you start by taking a lot of CE, you know…

Naren Arulrajah: In that, I do think it’s a good… a lot of people have, you know, a wish, but then very few people translate that wish into reality or success. And I think perhaps one of the things you and I should just brainstorm is, what are the steps? Like, I’ll share my thoughts, Gary, from a marketing perspective. And of course, you need to have the proper training—that goes without saying. So make sure you’re trained, and I think you have always said: do the things you love. Don’t do it because everybody else is doing it. Don’t do it because, you know, some lecturer said it’s very profitable. Do it because you love it, you enjoy it, you—

Gary Takacs: Love it. Yeah. But I would say there is likely something that I would define as a high-value service that would fit any of our listeners in terms of something they would love to do. It wouldn’t be—

Naren Arulrajah: Universal. So you’re saying start by looking at what’s the most productive in terms of dollars per hour worked. And then, of course, within that, pick the one that you love, or pick the ones that you love.

Gary Takacs: What would you spend thousands of hours of CE in? And look at it as, “Oh my gosh, this is what I love doing.”

Naren Arulrajah: And then, of course, you need to figure out a way to attract those patients. And of course, what is marketing? Helping people find you, like you, and trust you. On the “find you” piece, definitely, you know, it’s all about SEO, and are you showing up for dozens and dozens and dozens of keywords related to, for example, implants? And then of course they have to like you and trust you, so that’s where the cases come in. So start collecting those cases, especially the full-face after pictures and the beautiful smiles, and then showcasing them on your implant page. And that could take, you know, years sometimes, because you have to work at it. You have to have a strategy around it. I know, Gary, you recommend for the first few patients, even do it for free or at cost, so that way you can get those cases and get those stories in.

Gary Takacs: Well, let me get granular with that, Naren. Let’s say you wanna grow a high-value—let’s say you’re currently working four days a week and you wanna grow a high-value service. Now, I’m gonna deviate from the theme of this podcast slightly, because we’re talking about reducing your chairside time, right? Deviate from—so let’s go with veneers.

I think a lot of listeners would like to do more veneers, right? So you take a lot of CE, maybe go out and take a course from David Hornbrook, a hands-on course. You start feeling like, “Okay, I’ve got this.” As you start to schedule a what we call smile design—smile design would be eight- or ten-unit upper anterior porcelain veneer cases—I might suggest, if you’re working Monday through Thursday, schedule the first couple cases on Friday morning.

Gary Takacs: Hmm. Now, I’m violating the reducing-time theme — but stick with me on this. So now, just have an assistant come in. Don’t have hygiene going on, so you don’t have to get up and do hygiene checks. And you and your assistant can perfect the whole process of delivering that veneer case. The first appointment will be prepping and temporizing, and the second appointment will be seating that case. And it might be a four-hour appointment time — Friday morning from eight to noon. How’s that patient gonna feel getting your full attention, Naren?

Naren Arulrajah: Yeah. Like a VIP.

Gary Takacs: Oh my gosh, this is great. And you can take your time, you can work out all the different protocols — the room setup, the tray setups, all of that. Maybe you do a couple cases like that, and then you start to roll that into your regular schedule. Maybe that’s a four-hour block that you put in your schedule as a rock block. And that’s gonna be a boulder block — if we use the terminology rock, sand, water for the types of appointments we have, that’s going to be a boulder. Maybe we start blocking that in.

And I have a wonderful case study in my client base where exactly this — cosmetic dentistry — this is a doctor that got to the point where every Thursday, he was working still four days a week at that time, every Thursday was a smile-design case. He’d either have one or two patients on Thursday. If it was one patient, it would be a 28-unit case, upper and lower. If it was two patients, it might be a 10-unit prep in the morning, a different 10-unit prep in the afternoon. He had to get the marketing in place to provide that. He chose not to have hygiene on Thursday because he didn’t want to have to get up and do hygiene checks. And he said, “I’ll have double hygiene the other three days.”

So Monday, Tuesday, and Wednesday he was a regular general dentist. On Thursday, he was a cosmetic dentist. What day of the week do you think he liked best, Naren?

Naren Arulrajah: Monday, Tuesday, Wednesday… Thursday? Of course, I think he’ll enjoy the cosmetic piece. So you’re saying Thursday?

Gary Takacs: Nope. Wrong.

Naren Arulrajah: Oh, interesting.

Gary Takacs: Friday.

Naren Arulrajah: The free day. The day he doesn’t work.

Gary Takacs: It was Friday.

Naren Arulrajah: Trick question — you tricked me.

Gary Takacs: I tricked you. I tricked you. He did love his Thursdays, but he liked his Fridays even more.

Naren Arulrajah: Even better. Yeah, I guess so.

Gary Takacs: Why don’t we go to three days a week? Why don’t we go to you doing general dentistry Monday and Tuesday, and then on Wednesday do your cosmetic day? You could be just as productive as when you were doing dentistry four days a week. Now, the one problem that created — and this leads to the next step — is that wasn’t enough time for the general dentistry in his practice. So that led to a natural opportunity to bring an associate doctor in.

So now I brought an associate doctor in, and the owner doctor was able to work Monday, Tuesday, Wednesday, doing the things he loved to do on Wednesday. And then the associate doctor did more of the general dentistry. Of course, he mentored the associate doctor to be able to do other high-value services. And it really created a really nice way to grow the practice but reduce the owner dentist’s clinical chairside time.

Naren Arulrajah: Absolutely. And one tiny comment: if anyone is interested in really strengthening your ability to attract patients who are looking for those high-value, productive types of dentistry, we can definitely help — meaning Ekwa Marketing. Book a marketing strategy meeting. We can give you a strategy, a game plan. The link is ekwa.com/td.  And definitely, if you’re really serious, you also need to pay attention to marketing because you could do all of this expensive education and investment in time and money, but if you don’t have a methodology and a way to attract those patients, then you’re gonna be in trouble.

Gary Takacs: And they’re probably not gonna come from Delta. Can we agree on that?

Naren Arulrajah: Absolutely not.

Gary Takacs: I mean, they could. You could get a veneer case out of Delta. You could get an implant case out of Delta. But you know what the Delta patient wants, Naren?

Naren Arulrajah: Is it covered by insurance? It’s free.

Gary Takacs: They want their free cleaning. And that’s it. That’s all they want. They want their free cleaning. So if you want to be the free-cleaning doc, you might want to add a sixth clinical day.

Gary Takacs: Not three.

Naren Arulrajah: Especially when you’re working for pennies on the dollar, you probably need like seven clinical days. Maybe you—

Gary Takacs: Should be the guy that’s open seven days a week then.

Naren Arulrajah: Till 9 PM.

Gary Takacs: You actually have a practice in Phoenix — I’m not kidding, Naren — seven days a week, 7 to 7.

Naren Arulrajah: Oh wow. Seven to seven. That’s like 7-Eleven.

Gary Takacs: Exactly. It’s seven to seven, 7:00 AM. So they’re literally working seven… Now, it’s not one doctor, obviously.

Naren Arulrajah: Of course, it’s a team.

Gary Takacs: I mean, I didn’t mean anything derisive to the dentist that created that. He can have it. Good luck with that. He can have it. And again, I don’t mean anything derisive in that. But… no. No would be my response to that. Absolutely.

So yeah, you can have it all. And it’s interesting — dentists are always interested in improvement. They have a natural curiosity about improving, learning new things. What about improving your productivity per hour? And it doesn’t mean you have to be fast — crazy fast. It just means you’ve got better efficiencies, you’ve got better assisting capabilities, you’ve got a better mix of services that allow you to be more productive.

How many of our listeners measure your productivity per hour? It’s very interesting. And then what if you did that and you decided, okay, maybe instead of working 200 days of the year — 50 weeks, four days a week, that’s 200 — maybe next year you’re going to work 180. And then maybe the next year work 160. Maintaining or growing, while working less. It’s counterintuitive. But it works.

Naren Arulrajah: And if you take it one step at a time, I think it’s definitely possible. Gary, I have something that has been kind of bugging me as I was listening to you talk about this whole topic of working less without reducing the amount of revenue you generate. What do you think is the best practice model for someone who’s looking to reduce the number of days they spend doing clinical dentistry?

Gary Takacs: I can answer that very quickly, Naren. I think there are a number of models that can help us get there, but the model that I like is a two-doctor practice. It could be an owner and associate doctor, it could be partners, maybe the associate becomes a partner — but I think it’s a two-doctor practice spread out over a five-day work week, Monday through Friday.

So maybe one doctor works Monday, Tuesday, Wednesday; the other doctor works Wednesday, Thursday, Friday. Maybe they have an overlap day in the middle where they both work that day. Hopefully they have enough operatories to do that. And that way, maybe the owner doctor can be a mentor for the associate or the partner. That works for a lot of reasons.

Now we’ve got the doctors doing three-day weeks. You’ve got coverage to expand your availability for patients. And now we can offer our team members the opportunity to have a 40-hour week if that’s what they want. A lot of team members have pivoted over to corporate dentistry because they want 40-hour weeks. And what if we could offer that in a private practice setting? How cool would that be?

Again, if you have team members that want four days, we can certainly accommodate four days over that five-day schedule. So I think that’s a model that works for everyone. Bring an associate doctor in, and you can push some things downhill — some of the more everyday general dentistry that might be where our young associate doctor’s skill set is — and develop that skill set.

Maybe we choose some of the associate doctor’s interest in high-value services to be complementary to yours. So maybe you don’t like doing endo, but your associate does. Maybe we work on developing endo there. Go back to wisdom teeth for a minute: maybe you’re not interested in extracting wisdom teeth, but you have an associate doctor that loves surgery. And through a lot of CE — and again, I believe in multidisciplinary care here — and I want to make that comment with respect to our specialists that listen: I truly believe in multidisciplinary care. Stay in your lane. You should have a great specialist you can refer to — oral surgeon, periodontist, endodontist, orthodontist, pediatric practice, prosthodontist. But a lot of the more routine things within those specialties, you can do in your practice with the one caveat that you’ve invested in a massive amount of CE.

But I like that two-doctor model, and I think that can make perfect sense in terms of how to get there. And then, then you could be a three-day-a-week clinical provider — working three normal days. I’m not talking about three twelves, Naren. I’m talking about three normal eight-hour days. And you can produce just as much. And we’ve done it time and time again with our clients.

Naren Arulrajah: Gary, I love this idea of this two-doctor practice model. It works for the associate. And you and I have done this for 45 years, and we have seen horror stories, right? And the horror stories are not necessarily that they didn’t have the right idea — just that they didn’t take the right steps to get there. In other words, you can’t just flip a finger and all of a sudden you had one doctor, and now you have two doctors and everybody’s busy and happy three days a week. That doesn’t happen.

So can you kind of walk me through, based on your experience having seen people who have successfully gone from point A to point B, how they could think about it? I know it’s like one step at a time… maybe grow hygiene, maybe add one day… just walk me through some examples.

Gary Takacs: Well, I mean, if you’re a four-day-a-week clinical doctor and maybe you’re too busy — if you’re booked out more than a week to see a new patient — in other words, we can’t offer a new patient appointment within a week, then you have more demand than you can handle.

Naren Arulrajah: Is that the magic number? You know, you have one week? You are booked out one week in advance? Or is it more like three weeks?

Gary Takacs: For a non-urgent patient — so nothing’s urgent, nothing’s hurting, nothing’s an emergency — “I just moved to the area. I met my neighbor. They highly recommended your office. I’d like to make an appointment.” I’d like to offer that new-patient appointment within a week. So if it’s Wednesday today, I want to offer an appointment between now and next Wednesday.

Now if the patient says, “Right now I’m in a big project; I was thinking more like two or three weeks from now,” fine — push it off. But I want to offer within a week.

Naren, I do a lot of call training that we do for our clients. I literally listen to hundreds and hundreds and hundreds — if not thousands — of calls every week. The number one question that the public asks when they call — a new patient — what do you think that question is? I have data on this. What is the number one question they ask?

Naren Arulrajah: The two questions I can think of: one is around PPO — “Do you take my insurance?” — and then also “How quickly can you get me in?” Because they don’t want to wait.

Gary Takacs: You’re close. The number one question is: “Are you accepting new patients?”

Naren Arulrajah: Oh, right. When they’re calling, yeah, yeah, yeah.

Gary Takacs: Right behind it is “Do you take my [insurance]?” — my Delta, Travelers, Aetna, whatever. But: “Are you accepting new patients?”

And if we say, “Yes, my first available appointment is…” and it’s way out there — and if they found you by search, SEO (which you’re an expert at, Naren) — their connection to your office is very thin at that point. They’re going to go to the next office on the search results.

But if you’re a four-day-a-week dentist and you think, “I maybe have enough demand to add an associate, but I’m not sure if I have enough to add a full-time associate,” then go to the three-day week. Because now, if both doctors work three days a week, we’re going from four clinical days to six. And maybe the overflow you have in your demand is enough by itself — along with some marketing — to go from four to six. We’ve done that countlessly with our clients.

Naren Arulrajah: But sometimes the doctor you bring in is not a good fit. They don’t gel with the patients. They don’t gel with the team.

Gary Takacs: How do you figure that out ahead of time? You know…

Naren Arulrajah: You’re saying… but how do you figure that out?

Gary Takacs: It’s a professional marriage. It’s a professional marriage.

Naren Arulrajah: Right. But isn’t it like you have to date to figure it out? Or not really?

Gary Takacs: Spend the time ahead of time to learn about value systems, to learn about decision-making. Do your due diligence. And yes — it is literally dating before getting married. And if it is an associate, likely the first arrangement is as an associate doctor. If all goes well, it could lead to something else.

So do your vetting. Don’t just hire — vet. And bring that person in. And we go maybe from four days a week to both working three. We now have a six-day demand, and our marketing and overflow can handle that.

Naren Arulrajah: So you’re saying always have more demand than supply. Because if it’s the other way around, you’re going to get stressed.

Gary Takacs: You know, and if you’re a young doctor, as an associate — if you’re interviewing for an associate position and the owner dentist says, “Well, I don’t really have overflow; you’re gonna have to bring your own patients…”

Naren Arulrajah: Forget it.

Gary Takacs: No thank you. Keep looking. In fact, call me and I can help you find some great offices if that’s your interest. Offices that will keep you busy from day one. So make sure you’ve got your clinical ducks in a row — and that you’re passionate about dentistry — but yeah, there are some great opportunities out there.

But yes, that’s what I would do. You go from four days to six. You go from you working—

Naren Arulrajah: I think what you’re also saying is: take it step-by-step. Don’t just go from zero to 100. Go zero to five, five to 10, 10 to 15. So think through the steps. And maybe part of it is getting to know the associate — maybe have him work one day a week just so that everybody feels comfortable. Do they get along? Because some associates don’t jive with the team. The team rejects the associate like a membrane — they just push the associate out.

Gary Takacs: We have to get our team on board. And one of the things your team needs to understand is their role is not to be critical of the associate. Their role is to help the associate integrate into the practice.

Naren Arulrajah: Ah.

Gary Takacs: That’s a whole different mindset.

Naren Arulrajah: Interesting.

Gary Takacs: And you may have to have some one-on-one conversations because—

Naren Arulrajah: So you’re saying the default is to reject? Is that what typically happens?

Gary Takacs: Absolutely. They expect the associate to be you.

Naren Arulrajah: Oh, I see.

Gary Takacs: And the associate could be a different gender…

Naren Arulrajah: Different generation too — like the way they work.

Gary Takacs: Yeah. So their default is to not like anything they’re not familiar with. They’re not familiar with the associate. But let your team members know that their role — you’ve done the vetting, they wouldn’t be in your practice if you didn’t think this was going to work out. Now, it may not. But you need to have the situation where: “I wouldn’t bring this person into my practice if I didn’t believe that they were going to be a good…”

Naren Arulrajah: Oh, interesting. So you’re saying go all-in and really get everybody on board to make that person a success.

Gary Takacs: And together, if we discover that isn’t the case, then I’ll act accordingly. But we’re planning on this being a long-term, wonderful relationship for every one of you — and also for our patients.

Naren Arulrajah: Makes sense, Gary. What role does the hygiene department play in growing a practice while reducing the number of clinical days? And I’m thinking in the back of my mind — yes, it’s better to be more productive where you’re making more money for the same amount of time, but it’s even better if you don’t have to do anything and you’re making money, which is what hygiene…

Gary Takacs: Well, hygiene — it’s a critical role there, to answer your question. It’s not just a minor role. It’s a critical role.

Naren Arulrajah: It’s a critical role, yeah.

Gary Takacs: In our analytics, we like one-third of the total office production coming from hygiene.

Naren Arulrajah: Right.

Gary Takacs: And what we count as hygiene production is everything that happens to a hygiene patient, with the exception of the doctor exams. The doctor exam is credited to the doctor.

So if you have a $2 million practice, how much production are we expecting to come from hygiene? We have a $2 million practice…

Naren Arulrajah: $666,000.

Gary Takacs: There it is. Ding ding ding ding ding. So, in a simple way: owner doctor produces a third, associate doctor produces a third, hygiene produces a third. In a very simple model. It probably won’t measure out that evenly because the owner doctor is likely to be more productive. So it might be 40% coming from the owner dentist, a third coming from hygiene, and the difference coming from the associate doctor. Does that make sense? You’re starting to see the concept of the math around it.

Naren Arulrajah: And if I were to just summarize some of the things you mentioned so far: you want to make the same or more money compared to before, while working less. So one strategy is: if currently only 20% of your production is hygiene, figure out a way to raise it closer to 33%.

Gary Takacs: And you may get to the point where now you’ve got an exam problem — you’ve got too many hygiene exams to do — and that leads so nicely to an associate.

Naren Arulrajah: Oh. So now it creates even more work, because all these exams need a dentist…

Gary Takacs: Now it allows us to grow and not be burdened. Let’s face it: all of our listeners are probably competent doing two exams an hour. They don’t like to do two exams an hour. They prefer to have one. In fact, if the truth be told, they’d prefer to have none.

Naren Arulrajah: You know, the mindset you just shared really struck me. Like the quote: “You eat to live, not live to eat.” Same way here. Let demand decide if and when to bring an associate — not the other way around, where someone says, “Oh, I need an associate,” and plops one in, and it blows up because there’s not enough demand.

Gary Takacs: Remember, another factor is: if there are services you don’t do — things you turn away — look for an associate…

Naren Arulrajah: You’re saying you’re turning away a lot of services that people are asking for that you don’t do — like 30% of dentistry is root canals…

Gary Takacs: Root canal therapy — endo is a great example.

Naren Arulrajah: Yeah, yeah, yeah.

Gary Takacs: A lot of dentists don’t like doing root canals. And on the other hand, some dentists love it — they enjoy the precision of it. And you can have the technology: CBCT, a microscope, do endo — and now that’s additive to your practice. That’s not taking away from anything. That’s adding a service to your practice.

So many different ways. And, like so many answers, it depends. It depends on your practice, depends on your situation. But it absolutely can be engineered for sure.

Naren Arulrajah: But I think what you’re saying is: really focus on creating the demand, and make sure whatever predictions you’re making around demand are accurate. Only then bring in that extra person to fill that demand — not the other way around. Because a lot of people do the opposite. They just get an associate and then try to figure out how to get the demand. They don’t do marketing in advance. They don’t increase hygiene capacity to produce more at-bats for the doctors. All of these ideas you just shared.

Interesting. What systems help the doctor grow the practice even when they’re doing fewer clinical hours? That’s a good question, Gary.

Gary Takacs: Well, so systemize anything that repeats — anything that’s repetitive — whether it be clinical or admin or business.

Naren Arulrajah: Even the way you answer the phone, even checking your conversion rate — like what percentage of my new patients are booking appointments. Everything that can be systemized should be systemized.

Gary Takacs: Everything that repeats, we should systemize. Absolutely. So scheduling — do you have an ideal day? Do you have an ideal day template? If you don’t have an ideal day template, how can your scheduling coordinator help you schedule an ideal day? She doesn’t know what that is.

Naren Arulrajah: Can you give some color on what you mean by ideal day template, Gary?

Gary Takacs: Sure. I’ll take a minute and explain this. And again, your mileage may vary. I like to say that because I respect however a dentist wants to practice. But a very productive way is to think about having two columns and two assistants, okay?

Column number one is your production column. And the hours that I like an awful lot, by the way, are seven to four — clinically seven to four. Let me explain that for a minute. Seven to four gives you a seven o’clock and eight o’clock appointment before the traditional nine-to-five business hours. So we can accommodate people.

There’s plenty of data that shows that if you open up early morning appointments, those appointments will be kept much more likely than evening appointments. What happens in the evening, Naren?

Naren Arulrajah: Oh, I get busy. I get tired…

Gary Takacs: They stop at the bar on the way home, and they never get up. But if they start their day with a seven o’clock hygiene appointment, they tend to keep it.

So seven to four — there’s an hour lunch in there — it’s an eight-hour clinical day. Column number one has different rock blocks. I’m going to suggest three different rock blocks. “Rock” is simply terminology that means it’s more significant production.

And this is for everyday general dentistry — not your high-value services, because your rock may be one patient doing a 20-unit prep that day, and I don’t want to put that into this model because that isn’t something that doctors can predict as they get started. But what we can predict is everyday general dentistry.

So imagine that we have three rock blocks. Imagine that two are one-hour blocks and the other is an hour-and-a-half. What goes in there? Things that we define as more significant production: crown preps, a lot of fillings (if it’s a quadrant of fillings, they go in there), root canals, surgery.

So we have three rock blocks at different times of the day.

Naren Arulrajah: So two one-hour and one 90-minute.

Gary Takacs: Hour and a half, yes. And then we have whatever your appetite for new patients is — let’s say it’s two new patients a day. And if the doctor part of the new patient appointment is 30 minutes, we also have those blocked off in a different color in the schedule every day.

So now add the math up, Naren: four and a half hours. Three and a half plus another hour for new patients — four and a half. We have three and a half hours left. It doesn’t matter what we put in those three and a half hours because if we scheduled the rocks, we’re already at goal. Does that make sense?

Naren Arulrajah: Yeah, yeah.

Gary Takacs: And then the second column is your overflow column. You have an assistant and you have a room, but it’s an overflow column. What goes in the overflow column? Things that your assistant can help you do with restorative dentistry.

On a typical day in our client base, the overflow column is scheduled about 30% of the day — three-zero. It’s not because we don’t have patients to put in the other 70%, but it’s because whatever you’re doing in column one is captive, and you cannot be in two places at once. Oral surgery is captive. Endo is captive. The doctor part of the new patient appointment is captive.

But in the second column, you can do restorative dentistry — fillings, and in some cases crowns if you have expanded-function assistants. And then you can put auxiliary-driven procedures in column two.

Examples of auxiliary-driven procedures: whitening, delivering aligner trays (Invisalign trays do have some doctor time, but it’s minimal), night guards. And when you add that up it ends up being significantly more productive by working out of two rooms — but you only have to be in one room at a time.

Did I describe that in a way that makes sense, Naren?

Naren Arulrajah: Yes, Gary. That’s awesome. Gary, thank you so much. Now we have talked about systems. Let me talk about mindset. What is the main mindset shift that you think a practice owner/dentist needs to make if they want to thrive with fewer days doing chairside dentistry?

Gary Takacs: Well, you know, I really think it comes down to thinking like a leader, not just as a producer. The truth is, all your formal education is in productive dentistry — learning how to do the dentistry. How much CE have you done in leadership?

So now you’re the CEO of your dental company. You have to start thinking as the CEO of your dental company. And what does that look like? You can only get so far by growth in terms of just doing more, more, more, more, more. At some stage, that is ultimately flawed as a permanent approach. At some point the wheels will fall off. Make sense?

One of the goals we teach with our clients is a growth mindset. I think growth is part of being a thriving practice. You frame growth around helping more of your existing patients have great oral health and helping more people in your community have great oral health. And I like our clients to grow by at least 10% a year in collections — every year — whether you’re adding more providers or not. Whether you’re adding another hygienist, adding another doctor, we want to grow by at least 10% every year.

And so now you have to start thinking as a leader. You’ve got to think about what that leadership role is for you. And really make it a priority to grow and reduce your clinical chairside time. It’s a career extender for you. It’s an absolute career extender.

Thank you, Gary. This has been a fun topic, Naren.

Naren Arulrajah: It’s a really, really good topic, and I think it’s different from what we typically cover. And I think we looked at it from a different perspective. Many dentists want more freedom — that’s universal. We run the I Love Dentistry group — it’s a very active group with more than 10,000 dentists and practice owners. And I think I can argue that is something nobody says: “I want less freedom.” Everybody wants more freedom.

Now, as a practice owner, you have that freedom because you decide who you’re gonna hire, you decide what dentistry you want to do, you decide where you set up shop, you decide who you want on your team. So you have a lot of choices. But unfortunately, none of this is easy. It takes planning, it takes forethought, it takes leadership, it takes a data-driven approach. And if you do that, yes — you can reduce the amount of chairside dentistry you do while growing your practice and improving your quality of care at the same time.

Gary Takacs: As my very wise late grandmother taught me, Naren, “If it was easy, everyone would be doing it.”

Naren Arulrajah: Yes.

Gary Takacs: And you know what is easy? Signing up for every PPO plan you can.

Naren Arulrajah: That is true.

Gary Takacs: That’s easy. And by the way, you don’t need brilliant team members. You’re an order taker. When someone calls: “Hey, I’m calling, I’ve got Delta, I want my free cleaning.” How much skill do I need?

Naren Arulrajah: What’s the point of a life like that when you’re just an order taker and the only reason they’re coming to you is because it’s free?

Gary Takacs: You know, I believe the root cause of why so many dentists feel dissatisfied in their profession is because they’re taking care of patients who don’t appreciate them. All they want is their free cleaning. And I really believe that’s the root cause — because they’re surrounding themselves every day with people who don’t really value them. They value it because it’s free.

Naren Arulrajah: Exactly.

Gary Takacs: And you know the ultimate litmus test? When you successfully resign from PPO plans, the ones that leave are the ones that don’t appreciate you. They’re voting with their feet. Because they look at dentistry as a commodity: “I don’t care how much CE you’ve had; all I care about is — is it covered by insurance?”

I mean, how many times does a patient ask: “Can you tell me how many postgraduate hours of CE the doctor has?” I’ve listened to tens of thousands of calls. I’ve never heard that question. They do ask: “Do you take my insurance?”

Notice the difference: it’s a commodity.

Naren Arulrajah: Right.

Gary Takacs: “Hey, if you have a dental license, doesn’t matter where I go.” We know different. We know different. Hope we’re triggering some thinking here, you know? Here we are on the doorstep of a new year. By the way, I’ll join Naren in his opening and wish you all a very Merry Christmas. But maybe you’re thinking about the next year — thinking about 2026 — and maybe this episode is well timed to have you think a little differently about 2026.

Naren Arulrajah: Absolutely. And I would welcome everyone who hasn’t done so yet and is really serious about making 2026 perhaps your best year yet, to book a coaching strategy meeting with Gary. The link is thrivingdentist.com/csm.  Gary will meet with you. And I’ve seen Gary say, “Unfortunately, I don’t think I can help you.” He’s a straight shooter. He’ll tell you what he thinks — if he really believes he can make a difference.

Some people come to him for work-life balance. Others come because they want to drop PPO plans. Other people want every year to be their best year and they want the systems and KPIs — and they want Gary’s team to help them make every year their best year yet.

Gary Takacs: Well, Naren, if we bring it back to the title — if you want to reduce your clinical days and still grow — the next step is simple. Just schedule a coaching strategy meeting with me. That will open up my calendar. You’ll pick a time. You’ll meet with me. I’ll have a chance to talk to you, get to know your practice, get to know your goals, and determine whether this would be a good fit. And if it is, I’d love the opportunity to work with you and help you make 2026 your best year yet.

On that note, I’m going to take a minute and thank all of our listeners here at the Thriving Dentist Show. We appreciate each and every one of you. We appreciate the privilege of your time, and we truly do see that as a privilege. Thanks so much. Happy holidays. Let me also wish you a Happy New Year — and here’s to 2026 being your best year yet.