The work around the work: where a practice's week actually goes

Back in June we wrote about 4pm on a Tuesday, when somebody in your office is swearing at a screen.

This one is about 9:40pm on the same Tuesday.

The office is dark. You're at the kitchen table with a laptop. There are six chart notes to finish, a payroll run to approve, a time-off request you forgot to answer, and a report you promised yourself you'd look at two weeks ago. None of it is hard. All of it is yours.

Dentistry is the work. This is the work around the work.

A number we're not going to give you

The usual way to open a post like this is with a statistic: dentists spend some alarming number of hours a week on administration.

We went looking for one we'd be willing to stand behind and didn't find it. The figures that circulate come from small surveys with loose definitions, and they range from a couple of hours a week to something close to a second job. We'd rather not pick the scariest one and print it.

So instead of a number, here's an inventory. It's sorted into six piles. Count your own.

Pile 1: The phone and the schedule

Answering calls. Booking. Confirming. Rebooking the patient who cancelled at 7am. Working the recall list. Filling Thursday's hole. Calling back the voicemail from lunch.

This pile mostly belongs to the front desk, and it never ends. It's also the pile where the cost of falling behind is most direct: an unanswered call is an appointment somebody else books.

What software can take. Reminders and confirmations, without anyone pressing send. Routine calls: an AI receptionist can answer from the actual record and hand the call to a person when a person is needed. Calls, texts, and email for one patient in one thread, so nobody is reconstructing a conversation from three inboxes.

What it can't. The patient who is frightened. The patient who is angry. The decision to squeeze in an emergency when the day is already full. Those need someone who knows the practice and the person.

Pile 2: Insurance

Verifying eligibility. Reading the benefits breakdown. Estimating the patient's portion. Building the claim. Attaching the x-ray and the narrative. Chasing the claim that vanished. Working the denial. Appealing.

We wrote a whole post on why this pile is as deep as it is. The short version: most of it is rule-shaped, and most of the rules are knowable before the claim leaves the building.

What software can take. Benefits in front of you before the patient sits down, rather than after. Claims as a queue that shows what's stuck and why, instead of a list somebody has to go inspect. The repetitive assembly.

What it can't. The forty-minute phone call with a payer. Negotiating your fee schedule. Deciding whether a plan is worth staying in network for. Software can make the first one rarer. It does nothing for the other two.

Pile 3: The money

Collecting the patient portion at the desk. Setting up a payment plan. Sending statements. Following up on the balance that's sixty days old. Reconciling what the bank says against what the ledger says.

What software can take. Payment plans on a card on file. Statements and reminders that go out on schedule. An aging view that's current when you open it, not when someone exports it.

What it can't. The conversation with a longtime patient who has fallen behind. That's a judgment about a relationship, and it should stay with you.

Pile 4: The team

Building the staff schedule. Approving time off. Tracking hours. Running payroll. Calculating what an associate earned this period under whatever arrangement you agreed to three years ago. Hiring. Training. The hard conversation.

What software can take. The schedule, the time clock, time-off balances, and payroll that runs off the hours actually worked. Provider pay computed the way you actually pay it, whether that's a percentage of production, a percentage of collections, a base plus a bonus, or hourly.

What it can't. Hiring well. Keeping a good hygienist. Noticing that the front desk is quietly miserable. Culture is not a feature.

Pile 5: Knowing what happened

How was last month? Is treatment acceptance slipping? Which insurance plan is slow to pay? Why is the new associate's schedule lighter than it should be?

In most practices, answering any of these means someone exports a report, opens a spreadsheet, and assembles the answer by hand. So the questions get asked quarterly, if at all.

The report was never the point. Knowing is the point.

What software can take. A dashboard that tells the desk what matters this morning. Reports you set up once that arrive by email on the day you want them. Numbers that roll up across locations if you have more than one.

What it can't. Deciding what to do about what you now know.

Pile 6: The notes

This one is the doctor's own, and it's the reason for the kitchen table.

Every exam, every procedure, every conversation about a treatment plan needs a record. The clinical work took ten minutes. Writing it down takes another five. Multiply by a full day and the notes follow you home.

What software can take. Most of the typing. Say the exam out loud and the chart and the note get written while you're still in the room.

What it can't. The exam.

The pattern

Go back through the six piles and the same three kinds of work show up in each.

Doing. Tasks that repeat and follow rules. Send the reminder. Build the claim. Run the payroll. Nobody's judgment is improved by doing these by hand.

Finding. Noticing the thing that needs attention. The claim that's stuck. The balance that's aging. The hole in Thursday. This is the expensive kind, because when nobody goes looking, nobody finds out, and you learn about Monday's problem on Thursday.

Deciding. Judgment and relationships. Which patient gets the emergency slot. Whether to stay in a network. What to say to the hygienist. How this practice treats people.

The third kind is the reason you own a practice. It isn't a burden. It's the job you wanted.

The trouble is that the first two eat the hours the third one deserves. You end up making the decisions that matter most at 9:40pm, tired, after the doing and the finding are finally finished.

Why the distinction matters

Last month we wrote about the offer every practice owner eventually gets: someone takes the business off your hands so you can practice dentistry.

Here is the difference between that and software, as plainly as we can put it.

When an organization takes over the work around the work, it takes all three kinds. It has to. People who do the doing and the finding will, reasonably, start doing the deciding.

Software can only take the first two. It can send, build, run, check, and flag. It has no view on how long your hygiene appointments should be and no quarterly number to hit.

That limit is usually described as a weakness. For an owner who wants to stay one, it's the entire appeal.

An honest note about us

We've described what software can take in the present tense, and you should hold us to that. Everything named above is in the product and can be shown running. Some of it we've been doing for a while. Some of it is newer and will have rough edges.

Don't take a list on faith, ours or anyone's. Ask to see each item work, on data shaped like a real practice, with the awkward cases included.

Try this for a week

You don't need us for the useful part of this post.

For one week, keep a sheet of paper at the front desk and another in your own pocket. Every time someone does a non-clinical task, make a mark in one of three columns: doing, finding, deciding.

At the end of the week, look at the proportions. Then look at who made the marks, and when. Pay particular attention to anything in the first two columns with your initials next to it and a time after 6pm.

That's your list. Whatever you do about it, with us or with anyone, start there.

If you'd like to see how much of that list a system can take, the product page walks through it, and we do 20-minute demos on real data.

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PracticeCore AI is a modern practice management platform built for dental practices. One price (1% of what you collect), no per-seat fees, self-host option available. We talk to dentists every day. We write here when there is something worth saying.