A multi-location practice in a major metro area went from fragile growth to $7M+ in annual collections. Here is how we did it.
This case study documents how I helped a practice owner grow from a fragile $3.4M single-location practice to a $7M+ two-location operation. It addresses six of the most common problems I see in dental practices across the country: over-reliance on insurance, no KPI tracking, team dependency creating vulnerability, hygiene underperforming, Google reviews left to chance, and growth without operational foundation.
If any of that sounds like your practice, keep reading.
When this doctor first reached out to me in early 2021, he had built something real. His practice was busy, patients loved him, and his clinical reputation was growing. But underneath the surface, the practice was fragile in ways that could undo everything.
Ninety percent of patients were insurance-based. New patient flow had just collapsed from around 100 per month to 85 after a key team member was dismissed following a serious breach of trust. It was the first month in the practice’s history where year-over-year growth went negative.
His second location was running but not profitable. Hygiene had no formal production targets. There was no incentive system, no KPI tracking, no structured new patient protocol, and no systematic approach to Google reviews or call conversion.
He had seven chairs, a patient base that trusted him, and a genuine passion for dentistry. What he did not have was the operational foundation to scale any of it.
This is one of the most common inflection points I see. When a practice’s patient acquisition depends on one person rather than a system, a single personnel change can unwind years of growth overnight. Building a structured new patient experience that does not depend on any individual is one of the first things I address.
My first priority was not growth. It was foundation. Before he could add a floor, bring in specialists, or grow his team, the core systems of the practice had to work reliably and consistently.
The early work focused on building a proper incentive compensation structure for hygiene and front desk, installing a consistent Google review system with an accountable internal champion, separating doctor and hygiene scheduling into distinct coordinators with clear goals, and establishing the morning huddle as a daily operational anchor.
A key investment was developing a long-tenured admin into a true office manager. I worked with her directly on emotional intelligence, KPI interpretation, and team leadership. She became one of the most important people in the practice’s growth story.
As systems matured, I introduced a formal nine-KPI dashboard reviewed quarterly. Every underperformance was traced back to a specific system and corrected there. Accountability without guesswork.
When teams don’t have clear targets and no visibility into how they are performing, there is nothing to rally around. Incentive systems aligned to production goals change the dynamic entirely. The team stops working for a salary and starts working toward a shared outcome. This is one of the first systems I install.
| Metric | Before coaching (2021) | After coaching (2025) |
|---|---|---|
| Annual collections (primary) | ~$3.6M | $5.52M |
| Second location revenue | Unprofitable | ~$2M, best year ever |
| New patients per year | 1,167 | 1,619 |
| Treatment rooms | 7 (single floor) | 14 (two floors) |
| Hygiene occupancy rate | Not tracked | 93% (above 92% goal) |
| Hygiene % of total production | 34% (unmanaged) | 33% (benchmark maintained) |
| Google reviews | Inconsistent, no system | 1,100+ with 15+ new/month |
| Collections rate | ~98% | 106% (recovering backlogs) |
| Specialists on-site | None | Perio 2x/week, Endo 1x/week |
All figures reflect full-year 2025 performance. Coaching ongoing.
“This will be our best year by far. By over a million.”
Practice Owner, December 2024
