Building a Highly Productive Schedule with Fewer Patients

Building a highly productive schedule with fewer patients

By: John C. Cranham, DDS 
This topic originally appeared on PankeyGram.org. Dr. Cranham granted permission for igniteDDS to share with our readers.

When I’ve looked at and really studied my practice numbers over the years, my favorite has always been productivity per hour. I have aimed to focus on a low volume of patients who need advanced dentistry.

As my practice developed, I was able to earn more per hour on fewer patients. I was able to earn as much or more while working fewer hours, and my overhead went down because the office was open fewer hours.

Successful Dental Practices Focus on Productivity per Hour

Rather than just firing off from the hip and trying to make a treatment plan with the patient who is in the chair, I now invite them back for what I call an “advanced records visit.” Then I focus on making comprehensive records and studying those to create a well-thought-out treatment plan. The time spent planning the treatment may be an hour.

 When you become good at treatment planning, it may take as little as 20 minutes. But the idea is to do better dentistry for your patients and get to where you are working on about 12 big cases each month. I have found that doing more than that is exhausting and makes it difficult to maintain patience.

Creating a Schedule That Supports Your Workflow

As I gained experience and a steady flow of comprehensive cases, I realized the importance of structuring my days to support high-quality, uninterrupted patient care.

This meant dividing my schedule into two types of blocks:

  • Uninterrupted time for executing advanced treatment plans
  • Designated time for general dentistry and walk-in emergencies

We start each day with a morning huddle to review our schedule and ensure we’re aligned on treatment goals and any adjustments needed. I personally begin my day around 6:00 AM, using the early hours to review case records in peace, a habit that has become essential to maintaining both productivity and clarity.

You may find a different rhythm that works better for you. Schedules should evolve with your practice and personal life. There is no perfect one schedule that fits all dental practices all the time, what matters is that your workflow supports deep focus for complex cases and accommodates the general dentistry that keeps your base strong.

Effective Strategies to Reduce Cancellations and Rescheduling

Once I had a steady flow of big cases coming in and productivity per hour was high, I no longer felt the need to keep my office open long days or to offer evening appointments. I discovered that evening appointments were the ones patients most often cancelled. And when we cut back on our afternoon appointments a few years ago, patients were accepting once they heard it was because the team and I wanted to spend more time with our families.  

 You may discover that when there are fewer appointment slots available, your patients’ perceived value of them rises, and patient calls to cancel or reschedule diminish.

Starting out in practice means delaying the gratification of shorter workdays. It will take some time to get your steam engine rolling, but stay the course, balanced with being kind to yourself so you can keep going. Keep your vision alive and educate your patients toward the comprehensive dentistry that will serve them best. Be patient. Your low-volume/high-earning productivity per hour will grow slowly and then faster.

 At every stage of practice, I think there is one thing all dentists have in common. They relish the quiet hours when they are alone, planning treatment. Those are the hours when they feel most at peace, most able to solve complex problems, and actively create plans for efficiently delivering dentistry. As a young dentist, you might experience this once per month, and after a few years, you may experience this nearly every day. Those quiet hours are powerful hours for driving productivity. 

In Conclusion

It’s not about working less, it’s about working smarter, delivering better dentistry, and maintaining your wellbeing as a dentist. To offer more comprehensive care and build a highly productive schedule in your practice, I recommend you visit advanced educational courses at The Pankey Institute that take you from compromise to comprehensive treatment planning to become fully competent in delivering the complex treatments patients need. 

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Testimonials

Rosie, RDH

Rosie, RDH

I had the pleasure of working with Candy as a dental hygiene consultant over the course of several months, and her...
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Rosie, RDH

I had the pleasure of working with Candy as a dental hygiene consultant over the course of several months, and her impact on both our hygiene department and overall practice was exceptional. Candy is highly knowledgeable, approachable, and genuinely invested in the success of the team. She is an excellent listener who takes the time to understand challenges and provide practical, effective solutions. One of the qualities I appreciated most was her accessibility, she was always available to answer questions, offer guidance, or return a call when needed. Her hands-on approach and commitment to helping our team succeed were evident in every interaction. Candy’s focus extends beyond productivity and practice growth; she truly cares about the people within the practice and works to create a supportive, collaborative environment. As a fellow dental hygienist, it was especially refreshing to work alongside someone who shares a similar philosophy and approach to patient care, team development, and practice success. We view many aspects of dentistry and hygiene through the same lens, which made collaboration seamless and productive. Having the opportunity to work with another hygienist who understands the challenges, opportunities, and importance of our role was invaluable. The hygiene modules she developed were incredibly valuable. They were well organized, easy to follow, and provided clear, actionable guidance. The accompanying handouts and resources gave our team the tools and confidence needed to implement new concepts successfully. Her training materials were practical, relevant, and tailored to the real-world needs of a busy dental practice. Candy’s expertise and dedication to excellence have made a lasting impact on our team. I would highly recommend her to any dental practice looking to strengthen its hygiene department, improve systems, and support the growth and success of its team. She is a true asset to any practice fortunate enough to work with her.
Rosie, RDH
Dr. Justin Elikofer

Dr. Justin Elikofer

Our story with IgniteDDS began almost five years ago when my wife and I purchased an established fee-for-service practice. At...

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Dr. Justin Elikofer

Our story with IgniteDDS began almost five years ago when my wife and I purchased an established fee-for-service practice. At the time, we promised the team that everything would stay the same. The practice was thriving, and from the outside it seemed clear they had found a successful recipe for success. Our goal wasn't to change it—we simply didn't want to mess it up.

What we discovered was that while everyone wanted the outcome of success, there wasn't alignment around how we achieved it or measured it. Success in room 1 wasn't the same as Room 2. It took us nearly four years to fully understand that because we were doing well. During that time, we also realized we weren't leading as effectively as we could have been. We weren't communicating a clear vision, establishing consistent standards, or implementing clear protocols. Instead, we allowed people to continue doing things their own way. Some team members appreciated that freedom, while others felt frustrated by the lack of consistency and direction.

After four years, we found ourselves at a crossroads. We felt stuck. Morale was low and we weren't sure we could get the practice where we wanted it to go on our own.

As owners who value relationships as much as results, David immediately stood out to us. His personality was authentic, approachable, and trustworthy. He was someone we could see ourselves learning from and building a genuine relationship with. Being local was a bonus, but what really resonated with us was that his vision for practice growth, demonstrated through his own private practice, closely mirrored our own. He had already built the type of practice we wanted to create.

This stood in contrast to many other consultants we spoke with, whose focus seemed to be on PPO models and increasing volume. David's experience aligned with the type of practice we wanted to build: a high-touch, high-end patient experience centered on quality rather than quantity.

The IgniteDDS team—David, Dawn, and Candy—started by helping us understand where we truly stood. Through discovery, data gathering, and DISC assessments, they helped us identify opportunities for improvement and build a foundation for long-term growth. Rather than jumping straight to solutions, they gave us clarity.

Candy's coaching was instrumental in aligning our hygiene department and our office as a whole with the hygiene department. With her help, we were able to improve the patient experience and new patient process.

We also tackled practical issues that had become major challenges, including an accounts receivable system that was largely out of control. IgniteDDS didn't just point out problems—they provided systems and processes to solve them.

One of the most valuable aspects of the relationship was having experienced coaches to help us navigate team conflict and leadership challenges. As practice owners, those situations can feel isolating. Having a trusted team to walk through difficult conversations and decisions was invaluable.

Another large impact came through our office managers' work with Dawn. Rather than relying on the doctors to drive every initiative, IgniteDDS empowered our office managers to take ownership of the process and lead from within the organization. They embraced that responsibility wholeheartedly. No challenge was too large or too small. Dawn consistently met them where they were and helped them develop the confidence and skills to lead. The answer was rarely, if ever, "no." Instead, it was, "Let's figure out how."

Today, our practice is more aligned, more accountable, and better equipped to deliver the experience we've always envisioned. We have clearly defined protocols, team agreements, and expectations that simply didn't exist before. Our collections have improved significantly, particularly through implementing systems that helped us address and recover outstanding balances.

If we could offer one piece of advice to another practice owner considering IgniteDDS, it would be to identify the team members who are willing to take ownership and invest in their growth. Share your vision with the IgniteDDS team, trust the process, and allow them to help shape your team into the organization you want to become.

Working with IgniteDDS has been one of the most impactful investments we've made in our practice, our team, and our own growth as leaders. Are things perfect? No. Are we closer? Absolutely, yes!

Dr. Justin Elikofer
Dr. Sanjie Jackson

Dr. Sanjie Jackson

I was running on empty, and honestly, everyday I thinking of my exit strategy when I met Dr David Rice. ...
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Dr. Sanjie Jackson

I was running on empty, and honestly, everyday I thinking of my exit strategy when I met Dr David Rice. As the sole owner of two dental practices, I knew I couldn't continue trying to do everything on my own. Not if I wanted to grow and lead at a higher level. Partnering with IgniteDDS has been, hands down, one of the best investments I've made for both my practices and my team. Just halfway through my first year with IgniteDDS, the impact has already been remarkable. The knowledge, systems, accountability, and leadership development they have provided have transformed the way we operate. Not only have I gained valuable tools and insights as an owner, but my entire team is getting empowered with skills and confidence that are helping us elevate every aspect of our patient experience and practice performance. What sets IgniteDDS apart is the genuine commitment they have to their clients' success. Their guidance is practical, actionable, and tailored to the everyday realities of me running two dental practices. I am incredibly grateful for Dr. David Rice, Dawn, Candy, and the entire IgniteDDS team. Their expertise, continuous encouragement, and unwavering support have made me feel like I am not alone on this journey. If you're a practice owner looking to strengthen your leadership, improve your systems, and create sustainable growth, I cannot recommend IgniteDDS highly enough. The value they provide is truly exceptional, and I am excited to see what the rest of this journey brings.
Dr. Sanjie Jackson
Alyse Berta

Alyse Berta

Dawn, thank you for the great advice and guidance you’ve shared as we work on improving our practice's efficiency. I...
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Alyse Berta

Dawn, thank you for the great advice and guidance you’ve shared as we work on improving our practice's efficiency. I truly appreciate your support and the time you’ve taken to help us move forward in a more streamlined and effective way. Your insight has been incredibly valuable and is helping us make meaningful progress.
Alyse Berta
Dani S.

Dani S.

IGNITEDDS has made a real difference in our practice and in my role as office manager. The support I’ve received has...
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Dani S.

IGNITEDDS has made a real difference in our practice and in my role as office manager. The support I’ve received has helped me grow with more confidence and clarity, and our systems and leadership have improved because of it. Dawn has been an incredible support to me personally, always present, approachable, and truly invested in our success. I never feel alone when challenges come up, and that level of guidance and encouragement has been invaluable. IGNITEDDS doesn’t just support practices; they support the people behind them.
Dani S.
Eva B.

Eva B.

Working with IGNITEDDS Coaching has been such a great experience! Having David as a dentist makes a huge difference. He truly...
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Eva B.

Working with IGNITEDDS Coaching has been such a great experience! Having David as a dentist makes a huge difference. He truly understands the day-to-day challenges we face in practice. His insight makes their guidance practical, relevant, and easy to implement. Working alongside Dawn has been such a gift! She’s always available to answer questions, talk through ideas, and help us find the right solutions. Her advice is thoughtful, effective, and supportive. It hasn’t just helped me, it’s positively impacted our entire team and elevated our patient experience. I’m incredibly grateful to partner with Ignite as we continue to grow, strengthen our team, and serve our patients at a higher level.
Eva B.
Kylinn Tucker, RDH

Kylinn Tucker, RDH

I had an amazing experience with the IGNITEDDS Coaching program. Especially since I am a new hygienist, everything...
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Kylinn Tucker, RDH

I had an amazing experience with the IGNITEDDS Coaching program. Especially since I am a new hygienist, everything you guys shared was so helpful. It’s evident that you guys prioritize each individual team member of a dental office and do everything you can to make the environment and schedule run as smoothly and efficiently as possible. I learned so much about treatment planning, Dentrix, scheduling, teamwork, and overall ways to continue improving as a new grad. I wish every dental office had the opportunity to complete this program.
Kylinn Tucker, RDH
Dr Ben Truong

Dr. Ben Truong

It was great working with a team to help bring out the best in each of us. Our team is ...
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Dr. Ben Truong

It was great working with a team to help bring out the best in each of us. Our team is small, but we work closely together to provide a great patient experience, while having fun at work as well! Your team was able to help us learn to work together, with each person having a vital role in providing care to the patient! Helping us all become streamlined and on the same page will help us become an even more successful practice!
Dr Ben Truong
Dr. Ronnetta Sartor

Dr. Ronnetta Sartor

The 90-Day Jump Start has been transformative for our office. Dawn and Dr. Rice guided us through implementing essential systems ...
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Dr. Ronnetta Sartor

The 90-Day Jump Start has been transformative for our office. Dawn and Dr. Rice guided us through implementing essential systems and processes, from new patient calls to treatment planning and case acceptance. Their focus on patient care and team accountability has helped us create better structure, improve work/life balance, and stay aligned with our goals. In a short time, our practice has grown tremendously.
Dr. Ronnetta Sartor
Dr. Chandler Oldenburg

Dr. Chandler Oldenburg

IGNITEDDS has been truly transformative for our practice. Within just a few months, our accounts receivable collections increased by $30K, ...
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Dr. Chandler Oldenburg

IGNITEDDS has been truly transformative for our practice. Within just a few months, our accounts receivable collections increased by $30K, and our operations became far more streamlined. Their clear procedures and policies gave our team structure and confidence, while their step-by-step ownership guidance addressed our specific challenges. Thanks to David and Dawn, we feel more organized, empowered, and aligned than ever before. I highly recommend IGNITEDDS to any practice ready to grow and strengthen its foundation.
Dr. Chandler Oldenburg

John Cranham, DDS

Dr. John Cranham practices in Chesapeake, Virginia focusing on esthetic dentistry, implant dentistry, occlusal reconstruction, TMJ/Facial Pain and solving complex problems with an interdisciplinary focus. He practices with his daughter Kaitlyn, who finished dental school in 2020. He is an honors graduate of The Medical College of Virginia in 1988. He served the school as a part time clinical instructor from 1991-1998 earning the student given part time faculty of the year twice during his stint at the university. After studying from the greats in occlusion (Pete Dawson & The Pankey Institute) and Cosmetic Dentistry (Nash, Dickerson, Hornbrook, Rosental, Spear, Kois) during the 1990’s, Dr. Cranham created a lecture in 1997 called The Cosmetic Occlusal Connection. This one day lecture kept him very busy presenting his workflows on these seemingly diametrically opposed ideas. In 2001 he created Cranham Dental Seminars which provided, both lecture, and intensive hands on opportunities to learn. In 2004 he began lecturing at the The Dawson Academy with his mentor Pete Dawson, which led to the merging of Cranham Dental Seminars with The Dawson Academy in 2007. He became a 1/3 partner and its acting Clinical Director and that held that position until September of 2020. His responsibilities included the standardization of the content & faculty within The Academy, teaching the Lecture Classes all over the world, overseeing the core curriculum, as well as constantly evolving the curriculum to stay up to pace with the ever evolving world of Dentistry. During his 25 years as an educator, he became one of the most sought after speakers in dentistry. To date he has presented over 1650 full days of continuing education all over the world. Today he has partnered with Lee Culp CDT, and their focus is on integrating sound occlusal, esthetic, and sound restorative principles into efficient digital workflows, and ultimately coaching doctors on how to integrate them into their practices. He does this under the new umbrella Cranham Culp Digital Dental. Dr. Cranham has published numerous articles on restorative dentistry and in 2018 released a book The Complete Dentist he co-authored with Pete Dawson. In 2011 He along with Dr. Drew Cobb created The Dawson Diagnostic Wizard treatment planning software that today it is known as the Smile Wizard. Additionally, He has served as a key opinion leader and on advisory boards with numerous dental companies. In 2020 he published a book entitled “The Cornell Effect-A Families Journey Toward Happiness, Fulfillment and Peace”. It is an up from the ashes story about his adopted son, who overcame incredible odds, and ultimately inspired the entire family to be better. In November of 2021 it climbed to #5 on the Amazon best seller list in its category. Of all the things he has done, he believes getting this story down on paper is having the greatest impact.

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