The power of efficiency

Dr. Amy B. Jackson explores efficient scheduling and other details for reopening orthodontic offices.

Dr. Amy B. Jackson offers guidance on how to leave a time of uncertainty and get on the path to profitability

There is no question that COVID-19 has taught us a few things about how we live life and take things for granted. On the other hand, this pandemic has also taught us how to be creative again! Some of us have converted to a work-from-home lifestyle, while others were compelled to be resourceful and find new ways to make money altogether. Virtual meetings and hangouts have become the new norm, and most of us have taken a crash course in homeschooling our kids. In short, COVID-19 has changed our lives.

Keep swimming

We are leaving a time of certainty and entering a time of equal uncertainty. Many of us are left wondering how we will approach the same “business as usual” mindset as before. The answer may not be that simple.

Two dozen species, including the great white, the whale shark, and the mako shark, are known as “obligate ram ventilators,” meaning it is essential for them to keep moving to stay alive. Obligate ram ventilators pass water through their opened mouths and over the gills while in constant swimming motion so as not to asphyxiate. However, if for some reason the sharks decided to stop swimming, oxygen could not pass through their gills, and they would sink and die.

Much like the sharks, as orthodontists we must keep moving forward and continue engaging. Nevertheless, in this post-COVID-19 atmosphere, we must also evolve and seek solutions to patient and practice problems. Adaptability will be the key to success, and that starts with efficient scheduling.

Scheduling efficiently

With the unwelcome guest of COVID-19, we were forced to close our offices for weeks, causing a backlog of patients. Now, as we reopen, we must somehow find a way to accommodate existing appointments and the patients who were canceled, all the while making room for production.

Whether you are a young practitioner with a lean team or a seasoned orthodontist with limited openings in your schedule, it is imperative to your financial success that you leave space in your schedule to accommodate lengthier, more productive appointments.

Consider your daily schedule to be like a jar of time, which will be filled with rocks, sand, and pebbles. In this example, the sand represents the small and sometimes unnecessary appointments; the pebbles are the necessary appointments; and the rocks are important and productive appointments. If you fill up the jar with sand and spend all of your time on the less significant appointments, you will run out of room for those that are vital to the success of your practice.

In other words, maximize every face-to-face interaction with your patients, and put considerable thought into ways to free up chair time.

As I work to redefine my schedule building on rocks and pebbles, I have found a few of the strategies below helpful:

  • Deliver all aligners to the patient on the day of attachment delivery — with emphasis on patients carrying their attachment template and bringing it in when a repair is needed.
  • Instruct your front-desk administrators to triage patient calls and communicate those appointments that do not need immediate attention. We use the Weave software (Lehi, Utah) and ask patients to send images for more detailed
  • Fully implement and utilize Voice over Internet Protocol (VoIP): VoIP is a method that utilizes a group of technologies for the delivery of voice communications over Internet Protocol networks, such as the This allows the team to text/communicate with a phone or office computer. The average phone call takes 2 minutes, whereas a single text takes only 4 to 5 seconds. This change in protocol has allowed for 10 times the efficiency in inbound and outbound communications.
  • Arrange virtual visits for every other observation appointment, retainer checks, expander evaluations, and aligner advice. We have used Whats-App and Virtual Orthodontic Visit (VOV) (San Antonio, Texas) at
  • Eliminate as much paper as possible and create a portal so that all necessary paperwork is completed before the patient arrives at the office. With the help of your management software and DocuSign®, this can become a reality.
  • Offload color-change appointments and hygiene checks to nonessential days or virtual interactions.
  • Hire a dental professional to handle appointments that don’t require your expertise such as scans and braces removal.
  • Make bite turbos a regular part of the bonding process to minimize breakage from occlusal interferences.
  • Partner with After Ortho Revenue™ powered by Retainers for Life® to eliminate nonessential retainer appointments and minimize retainer emergencies.
  • Deploy self-ligating brackets into the practice with an emphasis on educating the patients about their value in combination with memory-shape wires to minimize the in-office appointments needed.

Time is the great equalizer. Choose how you spend your time wisely in order to position yourself to achieve your goals and maximize your practice profitability and customer satisfaction. It is time for all of us to redefine what we do, how we do it, and take back our time.


In a post-COVID-19 world, we need to make decisions that are smart, save time, and lead us to financially solid ground. As we move forward, this is an opportunity to set our intentions for the future, so take this time to improve your office systems.

  • Implement a plan to reduce chair time.
  • Eliminate paper in your office.
  • Weave virtual assessments into your everyday routine.
  • Add additional revenue without adding additional patients to your practice with After Ortho Revenue® powered by Retainers for Life™.

Although we all need to keep moving forward, the objective is to do so in a more thoughtful, productive, and streamlined manner. Don’t tread water — swim so that your business will not only survive, but also THRIVE!

For more information about Virtual Orthodontic, text or call 707-365-5622; Weave software, text or call 210-493-6067 after 6 p.m. CST for a complimentary consultation; and Retainers for Life, visit

Efficient scheduling is one way to promote profitability — Dr. James Reynolds discusses another area of productivity — assembling an effective office team. Read his article here:

Dr. Amy B. Jackson is a Board-certified orthodontist who graduated Magna Cum Laude from Baylor University and began her dental career in Houston where she attended The University of Texas Health Science Center. While at Houston, she was awarded a summer Research Fellowship from the AADR and the Barnard G. Sarnat Award in Craniofacial Biology from the IADR. Dr. Jackson continued her specialty training for orthodontics at The University of Texas Health Science Center in San Antonio. Her resident training included a master’s degree through the periodontal department and a research grant through the AAED for her published work with midpalatal implants.

Disclosure: Forestadent has partnered with her and her program Retainers For Life®/After Ortho Revenue™

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