Read this first

What this SOP is (and what it is not)

Every Market Manager gets pulled into the same three conversations over and over: "we need more new patients," "we need better patients," "we need more cosmetic cases." This SOP teaches you how to open Power BI, pull the number that actually answers each of those, and walk into the room with something smarter than a nod.

Every module follows the same seven-part shape: the conversation it answers, the metrics to pull, how to read them, the talk track, the guardrails, the common misreads, and what you do next when you find the signal. Read a module before its Thursday session. Come back to it after. The two pinned tabs at the bottom of the side nav are your in-the-moment reference — open them mid-meeting if you need to.

Paul's Rule #1

Widen the window. Single months lie. 3-month minimum, 6-month better, YoY for anything structural.

Paul's Rule #2

Structural before operational. Check practice status (closed / divested / transitioning) before you interpret ANY YoY comparison.

Paul's Rule #3

If the data looks wrong, it probably is. Don't argue in the room — file an incline ticket to sam@incline or manual@incline and come back with clean numbers.

Week 1 — Thursday 7/10

ROD Dashboard — The Front Door

This is the module everything else stands on. By the end of this hour, you'll be able to open Power BI, land on the ROD Dashboard, filter to your set (Gen4 or SGA, General Dentistry), pick a practice, and read the top-line story without getting lost in 45 tabs. You won't be a Power BI expert — you'll be someone who can walk into a room with a doctor and an OM and say something smarter than "we need more leads."

1Conversation this answers

Said in the roomWe need more new patients — marketing isn't doing enough.

What they actually meanSomething feels off and new patients is the easiest thing to point at. They may not know whether the problem is acquisition, retention, or the schedule itself.

What the data provesPull Net Production and Appointments Completed on a 3-month rolling window against last year. If completed appointments are flat or up but production is down, this isn't a new-patient problem — it's a value-per-visit or case-yes problem. New Patients on the ROD Dashboard tells you whether acquisition is actually down or steady.

Said in the roomWe're slammed — the schedule is full, we can't take another patient.

What they actually meanThe book LOOKS full because lead time is stretched way out. They're confusing a long lead time with real capacity.

What the data provesDoctor Lead Time and Hygiene Lead Time on the ROD Dashboard. If hygiene lead time is 37 days, the practice doesn't need marketing — it needs a hygienist or a template rebuild. If doctor is 8 days and hygiene is 26 days, that's a scheduling-template problem, not a demand problem.

Said in the roomLast month was terrible — production tanked.

What they actually meanThey looked at a single month and are reacting to it.

What the data provesWiden the window to 3 or 6 months on Net Production and Collections. Single-month dips lie — vacations, holidays, one lab week, one bad weather week. The Production Trend by Month view (current / next / next+1) will tell you if you're actually declining or just realizing production later.

Said in the roomOur numbers look wrong.

What they actually meanThey spot-checked one metric and it doesn't match what they see in the operatory.

What the data provesFirst: check practice status on the ROD Dashboard — closed, divested, transitioning practices produce garbage YoY comps. If status is clean and the data still looks wrong, they might be right. Submit a ticket to sam@incline or manual@incline before the next conversation. Don't argue in the room.

2Metrics to pull

Net Production (monthly + 3-month rolling)

Window: 3-month rolling, YoY

Why it mattersThis is the top line. Every conversation traces back here. But a single month tells you nothing — you need the rolling average to see the actual trend.

Good looks like3-month rolling Net Production flat or up YoY

Bad looks like3-month rolling Net Production down 8%+ YoY with completed appointments flat or up — that's a value-per-visit problem, not a demand problem

Doctor Lead Time + Hygiene Lead Time

Window: Current + 3-month trend

Why it mattersPaul calls this the killer signal. Lead time tells you whether the practice has a demand problem, a capacity problem, or a schedule-template problem. Get this wrong and you'll recommend marketing spend into a practice that needs a hygienist.

Good looks likeDoctor lead time under 5 working days, Hygiene lead time under 10 working days

Bad looks likeHygiene lead time 30+ days — do NOT recommend marketing. Or Doctor 8 days / Hygiene 26 days — that's a template imbalance, escalate to the ROD

Production Trend by Month (current / next / next+1)

Window: Rolling 3-month view

Why it mattersPaul's single biggest profitability lever. Are we realizing production sooner? If next-month and next+1 are climbing relative to prior periods, the practice is pulling production forward and cash flow gets better without a single new patient.

Good looks likeCurrent-month production trending up AND next+1 filling in earlier than same period last year

Bad looks likeAll production pushed to next+1 or beyond — the schedule is fake-full and cash is sliding right

Appointments Completed

Window: 3-month rolling, YoY

Why it mattersThis is your reality check on 'we're slammed' or 'we're dead.' If Net Production is down but completed appointments are flat or up, you've proven it's not a volume problem.

Good looks likeCompleted appointments flat or up YoY

Bad looks likeCompleted appointments down AND production down — now you have a compounding problem, dig into New Patients and Broken/No-Show %

New Patients (monthly)

Window: 3-month rolling, YoY

Why it mattersThe most-cited, most-misused number. Network-wide NPs are down 7% but it is NOT the dominant driver of revenue decline. You need to know it, but don't lead with it.

Good looks likeNew Patients steady or up YoY, or down slightly with strong Recaptured Patients offsetting it

Bad looks likeNew Patients down 15%+ AND Recaptured Patients flat AND Hygiene Reappointment low — now marketing conversation is warranted

Practice Status flag (Active / Closed / Divested / Transitioning)

Window: Current state

Why it mattersStructural before operational. Comparing a divested or transitioning practice to itself YoY is the #1 data trap. Check this FIRST, before anything else on this list.

Good looks likeActive, stable ownership, no transitions in the last 12 months

Bad looks likeRecently divested, mid-transition, or closed location still showing in the comp set — stop the analysis, flag it, move on

3How to read it

Start with the ROD Dashboard — not the 45 individual dashboards. Filter Legacy Company to Gen 4 (or SGA if you're looking at the full network), then Specialty to General Dentistry so you're comparing apples to apples. Second thing you do — before you look at any KPI — check practice status. If it's closed, divested, or transitioning, you're done, comp is trash. Third, widen the window: everything you look at should be a 3-month or 6-month rolling number, never a single month. Fourth, go straight to Doctor Lead Time and Hygiene Lead Time — that answers half the conversations you're about to have before you even get to production. Only then look at Net Production, Collections, Appointments Completed, and New Patients as a group. If a metric looks strange, cross-check on Go Grow (18-month rolling) or the NPG Month Summary before you say anything in a meeting. If it still looks wrong, submit an incline ticket — don't argue in the room.

4Talk track — say it like this

Before we talk about marketing, can we look at lead time together? If hygiene is booked out 30-something days, more new patients doesn't fix anything — we'd just be adding to the pile.
I want to pull up a 3-month view instead of just last month. One-month dips lie — vacations, holidays, one slow week. Let's see if the trend is actually moving.
Doctor, quick check — production is down but completed appointments are actually flat. That tells me this isn't a volume story. It's more likely a case-yes or case-mix story. Can we look at that together?
One thing I want to confirm before we go further — the practice status is still showing as active/stable, right? I want to make sure the YoY comp isn't picking up the transition period.
Let me look at the production trend for current month, next month, and the month after. What I'm trying to see is whether we're pulling production sooner or pushing it out — that's the biggest cash lever we have that doesn't cost anything.
If this number looks off to you, I trust that. Let me submit a ticket to incline and come back to you with confirmed data before we make a call.

5Guardrails — don't do this

Never recommend marketing spend (up or down) off a single-month reading. Widen to 3-month rolling minimum before you open your mouth.
Do not analyze a closed, divested, or transitioning practice on YoY comps. Structural check FIRST — always. If status is dirty, stop and flag it.
You are LEARNING to read these dashboards. For the first several doctor conversations, loop Paul (or Amy) in before or after the meeting. Don't freelance a diagnosis.
Don't share ROD Dashboard screenshots outside SGA. This data is internal — screenshot into a doc for your own notes only.
If the doctor says the data is wrong, don't argue in the room. Submit an incline ticket to sam@incline or manual@incline and come back with confirmed numbers.

6Common misreads

TrapReading a single month of Net Production and calling it a trend.

Why it's wrongOne month has too much noise — a lab week, a holiday, one provider on PTO, weather. Paul's rule: 3-month rolling minimum. If you react to a single month you'll recommend the wrong thing 40% of the time.

TrapSeeing a full schedule and assuming the practice is at capacity.

Why it's wrongA full schedule with 30-day hygiene lead time is not capacity — it's a bottleneck. The practice is turning patients away invisibly. This is Paul's Trish Takus / Beaumont example: the book looks full because hygiene lead time is stretched, not because demand is high.

TrapTreating New Patients and Net Patient Gain as the same number.

Why it's wrongA practice can be +344 new patients this month and -443 over 6 months on Go Grow. New Patients tells you what walked in. Net Patient Gain tells you if you retained anyone. Answering the wrong question sends you down the wrong recommendation.

TrapComparing a divested or transitioning practice against its own prior year.

Why it's wrongStructural change makes YoY meaningless. You'll show a 40% decline that has nothing to do with operations, then recommend a marketing intervention on a practice that isn't even fully staffed. Check status BEFORE you compare.

7Next step when you find the signal

If you find a lead-time problem (hygiene 20+ days, doctor over 5): flag it to the ROD before you say anything to the doctor. This is a staffing/template conversation, not a marketing conversation. If you find a value-per-visit story (production down, appointments flat), that's a case acceptance dig for next week's module — don't try to solve it in the room today. If practice status is dirty (closed/divested/transitioning), flag to Amy and pause the analysis. If the data itself looks wrong, submit an incline ticket to sam@incline or manual@incline, note it in your Marketing Tasks Smartsheet row for that practice, and bring the confirmed numbers to the next ROD meeting.

?Practice questions — can you actually do this?

Coming after Paul's Thursday session for this module. Self-check questions land here — real diagnostics, real practice names, real filter moves. When you get stuck on one, that's the escalation to Amy.

Week 2 — Thursday 7/17

Go Grow — Net Patient Gain and the 18-Month Rolling Window

Every practice you cover is going to tell you at some point, "we need more new patients." Nine times out of ten what they actually need is patients they already have coming back. This week you'll learn to open the Go Grow view, read a rolling 18-month window instead of last month's headline, and tell the difference between "we're not attracting" and "we're not retaining" — so when a doctor says "get us more NPs," you can come back with the number that actually explains what's happening.

1Conversation this answers

Said in the roomWe need more new patients — marketing isn't working.

What they actually meanProduction feels soft and I'm blaming the top of the funnel because that's the part I can see.

What the data provesPull New Patients last 3 months vs same 3 months last year AND Net Patient Gain over the trailing 18 months. If NPs are flat or up but NPG is negative, the leak is retention, not acquisition.

Said in the roomWe had a great month — 40 new patients in June.

What they actually meanOne month felt busy so I want to declare victory.

What the data provesLook at the 18-month rolling window in Go Grow. A single 40-NP month means nothing if the trailing average is 22 and NPG is still under water. Widen the window.

Said in the roomWhy aren't the new patients from our ads showing up?

What they actually meanI don't trust that marketing is producing anything.

What the data provesNew Patients trend + Recaptured Patients + Hygiene Reappointment % together. If NPs are landing but hygiene reappointment is under 85%, the ads worked — the office isn't holding the patients once they're in.

Said in the roomWe're growing, right? I feel like we're busier.

What they actually meanI want reassurance without looking at the numbers.

What the data provesNPG Month Summary. Rolled-on vs rolled-off patients over 6 and 12 months. Busy-feeling months and net gain are different things.

2Metrics to pull

New Patients per month

Window: 3-month average, then 12-month YoY comparison

Why it mattersThis is the number every doctor and OM asks about first. You need to know it cold so you can immediately pivot the conversation to the numbers that actually matter.

Good looks likeTrailing 3-month average at or above the trailing 12-month average, and both above same-period prior year.

Bad looks likeSingle-month spike or dip more than 25% off the 3-month average — that's noise, not signal.

Net Patient Gain (NPG)

Window: 18-month rolling window in Go Grow, checked at 6mo and 12mo intervals

Why it mattersThis is the one that answers 'are we actually growing?' NPs coming in minus patients rolling off. A practice can post 30 new patients a month and still be shrinking.

Good looks likePositive NPG sustained over 6 and 12 months. Rolled-on is beating rolled-off.

Bad looks likePositive NPs but negative NPG — you're pouring water into a bucket with a hole in it.

Hygiene Reappointment %

Window: 3-month average

Why it mattersThe single biggest retention lever. If patients aren't leaving with their next hygiene visit on the books, NPG will bleed no matter how many NPs marketing sends.

Good looks likeAbove 85% consistently, ideally 90%+.

Bad looks likeUnder 80%. Under 70% is a fire — no marketing dollar fixes this.

Recaptured Patients

Window: 6-month trend

Why it mattersPatients who dropped off and came back. Tells you whether the practice's reactivation game is working. Cheaper than acquisition every time.

Good looks likePositive month-over-month, and rising as a share of total scheduled patients.

Bad looks likeFlat or zero — nobody is working the recall list.

Appointments Completed

Window: 3-month and 12-month YoY

Why it mattersVolume reality check. If NPs are down but completed appointments are flat or up, the practice isn't shrinking — the mix is shifting. That changes the whole conversation.

Good looks likeFlat-to-up trend against 12-month prior; matches or exceeds provider capacity.

Bad looks likeDown more than 5% YoY at the same time NPs are down — that's a real volume problem.

New Patient Case Acceptance %

Window: 3-month average

Why it mattersIf the practice IS getting NPs but they're walking out without accepting treatment, the marketing worked — the front-office/doctor handoff didn't. Different conversation.

Good looks like60%+ NP case acceptance.

Bad looks likeUnder 45%. The NPs are coming; the office is losing them at presentation.

New Patient Trend (Go Grow header stat)

Window: Latest MONTH vs trailing 12-month average (directional, not a total)

Why it mattersThe number Go Grow labels "New Patient Trend" is NOT the count of NPs in your selected period — it's the latest single month vs the trailing 12-month average. A direction signal, not a total. Read it as a period count and you'll contradict the actual NP counts sitting three inches away in the same view.

Good looks likeTrend positive AND consistent with the 3-month rolling NPs you already pulled.

Bad looks likeTrend up while 18-month NPG is down — a hot month sitting on top of a shrinking base, not a growth story.

Limited-to-Comprehensive Conversion %

Window: 3-month rolling; check limited-visit share of total NPs at the same time

Why it mattersPaul's baseline: about 55% of new patients arrive as limiteds, not comps. The leverage point in the whole NPG conversation is NOT top-of-funnel — it's converting those limited visits into comprehensive exams. A practice can add 10 NPs a month with marketing spend and still go backwards if limited-to-comp is flat.

Good looks likeLimited-to-comp conversion trending up quarter-over-quarter; comprehensive share of NPs above 50%.

Bad looks likeLimited share at 55%+ AND conversion flat or falling — spend recommendation is premature until this moves.

3How to read it

Start in the ROD Dashboard, filter Legacy Company to Gen 4 or SGA, and Specialty to General Dentistry — that gives you a comparable set. Then jump into Go Grow and set the window to 18 months rolling; do not look at a single month first, ever. Read three lines side by side: New Patients trend, Net Patient Gain, and Hygiene Reappointment %. If NPs are up but NPG is flat or negative, stop looking at the top of the funnel — the story is retention, and you go to NPG Month Summary and the Provider Hygiene Report to find where patients are rolling off. If NPs are down AND NPG is down AND Appointments Completed is down, then and only then is this actually a demand conversation. When any single number looks weird versus the neighbors, widen the window before you say a word — one bad Monday can drag a month.

Filter hygiene, before you touch anything. Every filter you set in Power BI persists to your login until you clear it — including into tomorrow morning. So duplicate the tab BEFORE you filter, and keep the untouched original alongside the one you're slicing. Turn the hygienist tab off if you're looking at doctor-only production. Toggling Medicaid on/off will change the story on a mixed-payor practice — try both. If a single provider or single month is skewing the view (deceased provider, one-week PTO, a corrupt row), right-click → Exclude, and always screenshot the filter menu button so anyone reading the screenshot can see exactly what you excluded and why. Green back arrow resets all filters — use it before you close the tab.

Paul's 2-of-3 outlier rule. Watch three lines together over a quarter — Net Patient Gain, New Patient Trend, and Revenue. If two of three are down in a quarter, dig in — it's a real signal. One of three down is noise most of the time; don't escalate off it.

The limited-to-comp lever. Roughly 55% of new patients arrive as limiteds (limited-visit codes, not comps). The leverage point in this whole conversation is NOT the top of the funnel — it's the conversion from limited to comprehensive exam. Before you recommend a single marketing dollar, pull the limited-visit share and the conversion rate. If the leak is here, spend won't fix it.

Go Grow flags it, RAW diagnoses it. Go Grow is where you spot the anomaly (NPG down, trend flip, limited-share creeping up). The Days-to-Schedule view on the RAW dashboard is where you diagnose it — Paul's target is roughly 9 days. If DTS is running long, the acquisition story is really a capacity story. Chain the two reports together every time; a Go Grow read without the RAW cross-check is half a diagnosis.

4Talk track — say it like this

Before we talk about marketing, can we look at one number together? Over the last 18 months, are we rolling on more patients than we're rolling off? Because that's the growth question — new patients this month is just one input.
You're right that NPs are down a little. But your appointments completed are flat and your hygiene reappointment is at 78%. I think we have a keeping-them problem more than a getting-them problem — can we walk through that first?
Give me a second before I take a marketing spend recommendation back to the ROD. I want to look at the 3-month average, not just June, and I want to compare it to the same 3 months last year. One month can lie to us.
Doc, the NPs are actually landing — you got 34 last month. What I'm watching is that only 51% accepted a treatment plan. Can we talk about what's happening in that presentation conversation before we spend more to send more?
I don't want to guess in this room. Let me pull the NPG Month Summary and the Provider Hygiene Report tonight and come back with the numbers on Thursday — I'd rather be right than fast.

5Guardrails — don't do this

Never recommend increasing or cutting marketing spend based on a single month of NP data. Widen to 3-month, then compare to same-period prior year, before you say anything in the room.
Do not walk a doctor through Net Patient Gain in a live conversation until you have shown Paul (or Amy) the read first. This is a new lens for MMs — get the interpretation checked before you own the conversation.
Before you analyze YoY NPG at a practice, check whether the practice is closed, divested, or transitioning. A structural change will make a healthy practice look like it's collapsing.
Do not conflate Net Patient Gain with New Patients in front of a doctor or OM. They answer different questions and using them interchangeably will erode trust in the data.
Do not screenshot Go Grow or NPG Month Summary and send it outside SGA. This is internal-only data — share screens live if you need to, do not export.
Never filter Go Grow (or any Power BI view) on the tab you plan to keep as your baseline. Duplicate the tab first — every filter you set persists to your login, silently, into tomorrow morning. That's how "the numbers changed overnight" happens.
Never share a filtered screenshot without also capturing the filter menu button. If you excluded a provider, a month, or a payor, the person reading the screenshot has to be able to see what you removed and why — otherwise you're handing them a number that looks decisive but isn't reproducible.

6Common misreads

TrapReading a strong single-month NP count as growth.

Why it's wrongOne good month can sit on top of a shrinking 12-month trend and a negative NPG. Always check the rolling window before you celebrate.

TrapQuoting Go Grow's "New Patient Trend" as if it's the NP count for the selected period.

Why it's wrongNew Patient Trend is the latest MONTH vs the trailing 12-month average — a direction signal, not a total. Read it as a period count and you'll contradict the actual NP numbers sitting inches away in the same view. When trend is up and NPG is down, the story is a hot month on top of a shrinking base — not growth.

TrapOne quarter of NPG down = the practice is in trouble.

Why it's wrongPaul's 2-of-3 rule: NPG, New Patient Trend, and Revenue watched together. One of three down in a quarter is almost always noise. Two of three down is signal — dig in. Escalating off a single line will burn your credibility with the ROD.

TrapAssuming that NPs down = marketing broken.

Why it's wrongNPs down while Appointments Completed and Hygiene Reappointment are healthy usually means the schedule is full of retained patients — a good problem, not a marketing problem.

TrapComparing a practice's YoY without checking practice status.

Why it's wrongIf a practice is transitioning, lost a provider, or shrunk its schedule intentionally, YoY declines are structural. Recommending marketing spend against a structural change makes the MM look uninformed.

TrapUsing 'Net Patient Gain' and 'New Patients' as if they mean the same thing.

Why it's wrongNew Patients is a top-of-funnel count. NPG is a net-of-attrition number. A practice can be strong on one and negative on the other in the same month — mixing them up will give the doctor the wrong answer.

Live from Paul Real practices, real reads

Community Shores Dental Delta influx · 57% limiteds

What Go Grow showedThree neighboring practices went out-of-network with Delta. Community Shores absorbed the runoff — Delta NPs surged, but limited-visit share of NPs was running around 57%.

Paul's readLooks like an acquisition win. It isn't. At 55%+ limiteds the leverage is conversion, not top-of-funnel — more Delta-targeted marketing against an un-converting intake doesn't move NPG. Fix limited-to-comp before you recommend a single spend dollar.

ILP El Paso Provider death · right-click Exclude

What Go Grow showedNPG line falls off a cliff. The reason isn't operational — a doctor unexpectedly died mid-period, and their column is dragging the whole practice's number down.

Paul's readRight-click → Exclude on the deceased provider so the NPG line reflects the ongoing practice, not the transition. Then screenshot the chart AND the filter menu button — the ROD has to be able to see what you excluded and why. Never share a filtered view without the filter menu in frame.

Community Shores ← Portage Consolidation · inflated baseline

What Go Grow showedPost-consolidation, 18-month NPG at Community Shores looks like a growth story. A meaningful chunk of the "gain" is absorbed Portage patients, not organic acquisition.

Paul's readStructural change makes the baseline artificial. Widen the window past the merge date OR annotate the merge point on any chart you share. Comparing to a pre-consolidation baseline as if it's like-for-like is how the ROD walks away thinking a practice is outperforming when it's just eating another book.

7Next step when you find the signal

If NPs look fine but NPG is negative and hygiene reappointment is under 85%, this is a retention story — bring it to the ROD before the next practice visit and frame it as an operational (hygiene template, recall, reactivation) conversation, not a marketing ask. Log the finding in the Marketing Tasks Smartsheet under that practice so the ROD, OM, and Paul can see the same read, and flag it in the next ROD meeting so the recommendation for that practice is retention-first, not spend-first.

If it's becoming a marketing-spend ask, force it into a category before you take it anywhere. Paul recognizes three: branding (awareness), specialty (ortho, endo, implants), or discounts ($99 new-patient specials and the like). "We need marketing" is not a specification. Make the doctor or OM pick one — the conversation, the budget, and the vendor are different for each.

Chain Go Grow → RAW before you escalate. If Go Grow flags an NPG or trend anomaly, jump into the RAW dashboard's Days-to-Schedule view before you write it up. If DTS is well above the ~9-day target, this isn't an acquisition ask — it's a capacity ask, and the recommendation changes. Do not send Paul or the ROD a Go Grow finding without the RAW cross-check.

If the numbers look wrong or don't reconcile with what the OM is saying in the room, do not argue the point — submit a ticket to sam@incline / manual@incline that night and confirm before your next conversation with that practice.

?Practice questions — can you actually do this?

Three nearby practices go out-of-network with Delta and Community Shores absorbs the runoff — Delta NP intake surges and limited-visit share of NPs is running 57%. Do you (a) recommend more Delta-targeted marketing, (b) run Paul's checklist and confirm limited-to-comp conversion first, or (c) escalate to the ROD as an acquisition win? Read(b). At 55%+ limiteds the leverage is conversion, not top-of-funnel. Spend against an un-converting intake doesn't move NPG.
A doctor at ILP El Paso passes away unexpectedly. The NPG line shows a cliff. Before you take the number to the ROD, what's the correct filter move — and what has to be in the screenshot alongside the chart? ReadRight-click → Exclude on the deceased provider so the NPG reflects the ongoing practice, not the transition. Screenshot the chart AND the filter menu button so the ROD can see what you excluded and why. Never share a filtered view without the filter menu in frame.
Go Grow shows New Patient Trend at +12% while the 18-month rolling NPG is negative. In one sentence, explain what's actually happening — and which conversation you'd open with the doctor first. Read"New Patient Trend" is the latest month vs the trailing 12-month average, not a period count — one hot month sitting on top of a shrinking base. NPG negative = retention leaking under it. Open the retention conversation (hygiene reappointment, recall, reactivation), not the acquisition one.
Paul's 2-of-3 outlier rule — which three metrics do you check together over a quarter, and how many need to be down before you dig in? ReadNet Patient Gain, New Patient Trend, and Revenue. Two of three down in a quarter = signal, dig in. One down = noise, don't escalate off it.
Portage was consolidated into Community Shores mid-window. How does that distort the 18-month rolling NPG, and how do you keep the ROD from misreading it? ReadThe consolidation inflates the baseline — a chunk of the "gain" is absorbed Portage patients, not organic acquisition. Widen the window past the merge date OR annotate the merge point on any chart you share. Don't compare to a pre-consolidation baseline as if it's like-for-like.
A doctor says "we need marketing." Before you continue the conversation, what do you make them pick, and why? ReadA category: branding (awareness), specialty (ortho/endo/implants), or discounts ($99 new-patient specials and the like). "We need marketing" is not a specification. Budget, vendor, and success metric differ per category — you can't escalate a shapeless ask.

Week 3 — Thursday 7/24

New Patients — Actual Acquisition Data, Not the Vibe

Every doctor and every OM in every room you walk into is going to say the same thing this year: "we need more new patients." Your job this week is to stop nodding at that and start pulling the number. Because when the data comes out, one of two things is true — either the phone actually is quieter (an acquisition problem), or people are calling, we're booking them 26 days out, and half of them ghost us (a conversion problem). Those two problems get fixed by two totally different things, and you don't want to spend marketing dollars on the wrong one.

1Conversation this answers

Said in the roomWe need more new patients — marketing has to do something.

What they actually meanProduction feels soft and the doctor is blaming the top of the funnel because that's the visible part. They usually don't know if NPs are actually down or if the ones we're getting aren't converting.

What the data provesNew Patients by practice-month on a 3- and 6-month average tells you if acquisition is really down or flat. If NPs are flat or up and production is down, it's a conversion / case-acceptance problem, not a marketing problem.

Said in the roomOur marketing isn't working — the leads are junk.

What they actually meanThe OM is seeing new patients on the schedule but not seeing them turn into treatment. They're calling it a lead-quality problem when it's usually a lead-time or NP Case Acceptance problem.

What the data provesCross NP Case Acceptance %, New Patient Lead Time, and Broken/No-Show % for NPs. If lead time is >14 days and NP no-show is elevated, the leads are fine — the schedule is eating them.

Said in the roomThe doctor next door is stealing our new patients.

What they actually meanThe doctor sees their NP count as an isolated number and assumes it's a market-share problem. They rarely realize 60% of NPs in the network go to the top 20% of practices — Pareto, not competition.

What the data provesRank NPs across the ROD's book on the ROD Dashboard filtered to General Dentistry. If this practice is mid-pack and the top-decile practices in the same market are stable, it's not theft — it's a demand-share pattern, and the fix is operational (lead time, online scheduling, NP conversion), not more spend.

Said in the roomTurn up the marketing, we can handle it.

What they actually meanThe doctor wants volume. They haven't looked at Hygiene Lead Time or Provider Days Worked to see whether the schedule can even absorb more NPs.

What the data provesNew Patient Lead Time + Hygiene Lead Time together. If the practice is already booking NPs 3+ weeks out, adding leads makes the no-show problem worse, not better. You'd be pouring water into a leaky bucket.

2Metrics to pull

New Patients by practice-month

Window: 3-month and 6-month rolling; YoY on the same 3-month window

Why it mattersThis is the actual acquisition number. Everything else in this conversation is downstream of it. Never quote a single month — the noise is huge.

Good looks like3-month rolling NP count flat or up vs the same 3 months last year, and stable across the last 6 months

Bad looks like3-month rolling NP count down 15%+ YoY AND down vs the trailing 6-month average

New Patient Lead Time

Window: Current + 3-month average

Why it mattersPaul's killer signal. If a new patient calls today and can't get in for 3 weeks, half of them will find someone else or no-show. This turns a marketing win into a wasted appointment slot.

Good looks likeUnder 7 working days for a new patient exam

Bad looks like14+ working days, especially if Hygiene Lead Time is also elongated

NP Case Acceptance %

Window: 3-month and YoY

Why it mattersNew patients are your one shot to earn trust and get treatment plans said yes to. If NPs are showing up but not accepting treatment, adding more NPs doesn't fix the production problem — it just burns chair time.

Good looks likeNP Case Acceptance % in line with or above the ROD's book, and stable/up YoY

Bad looks likeNP Case Acceptance % declining YoY while Presented $ is up — that's the network-wide pattern (Presented up ~2.4%, Accepted down ~10%) and it's the real story under 'we need new patients'

Broken Appointment % and No-Show % (NPs specifically)

Window: 3-month rolling; compare to same period prior year

Why it mattersNP no-shows are a schedule-integrity signal, not a patient-quality signal. Broken up 27% and no-shows up 37% network YoY means we're losing NPs before they ever sit in the chair.

Good looks likeNP no-show % well below the practice's overall no-show %, and trending flat

Bad looks likeNP no-show or broken % running higher than the practice average, especially paired with long lead time

DI Online-Scheduled New Patients

Window: 3-month; also look at trend since online scheduling went live

Why it mattersTells you if the digital funnel is actually delivering booked appointments, versus calls that never convert. Also the easiest way to see whether website / GBP work is landing.

Good looks likeOnline-scheduled NPs a growing share of total NPs month over month; practices with online scheduling live are converting

Bad looks likeZero or near-zero online-scheduled NPs at a practice where the website has scheduling live — means it's broken, buried, or not being offered

Net Patient Gain (from Go Grow / NPG Month Summary)

Window: 18-month rolling

Why it mattersNew Patients is only half the equation. If we rolled on 344 NPs this month but rolled off 443 patients over 6 months, we're going backwards even though the NP number looks fine. This is the metric that tells you whether the practice is actually growing.

Good looks likeNet Patient Gain positive across an 18-month rolling window

Bad looks likeNPs holding steady but Net Patient Gain negative — retention problem masquerading as an acquisition problem

Presented $ vs Accepted $ (Case Acceptance $)

Window: 3-month rolling and YoY

Why it mattersThe network tell. Presented is up, Accepted is down. Doctors are recommending more treatment; patients are saying no more often. If you don't pair this with the NP conversation, you'll get talked into a marketing spend that can't move the number.

Good looks likeAccepted $ tracking with or above Presented $ growth

Bad looks likePresented $ up YoY and Accepted $ down or flat — case yes-rate is the leak, not the funnel

3How to read it

Start on the ROD Dashboard, not a single-practice view — filter Legacy Company to Gen 4 (or SGA, depending on which book you're covering) and Specialty to General Dentistry so you're comparing apples to apples. Look at New Patients by practice-month on a 3-month rolling average first, then a 6-month; if those two disagree, trust the wider window. Then click into Provider Hygiene Report to check Hygiene Lead Time and Doctor Lead Time side by side — if lead time is long, park the "we need more marketing" conversation, because adding NPs to a schedule that can't seat them is how you generate no-shows. Cross-check Net Patient Gain in Go Grow or NPG Month Summary — an 18-month rolling window will tell you if NP wins are actually net wins or just replacing patients we lost off the back end. Only after all of that do you look at NP Case Acceptance % and Presented vs Accepted $ — that's where you'll usually find the real leak. If one number looks crazy, don't die on the hill; submit a ticket to Incline and confirm before you take it into a room with the doctor.

4Talk track — say it like this

Before we talk about marketing, can we look at how many new patients you actually saw the last three months compared to last year? I want to make sure we're solving the right problem.
I pulled our new patient lead time — right now if someone calls today, we're booking them out about [X] days. Paul's rule of thumb is under a week. Would it help if we looked at the schedule template before we spent another dollar on ads?
Our new patient count is actually up. What's down is case acceptance — you're presenting more treatment and patients are saying no more often. That's a totally different fix than more leads.
I want to show you something on Go Grow. We rolled ON [X] new patients over the last 6 months, but we rolled OFF [Y]. That's why the schedule feels the same — we're running to stand still on retention, not on new patients.
60% of the new patients in our network go to the top 20% of practices. Our practice isn't in that top group yet, and it's not because our marketing is worse — it's usually lead time and how NPs get handed off on the first visit. Can we look at those two things first?
This looks off to me. Before I bring it back to you or the ROD as a conclusion, I want to submit a ticket to Incline and make sure the number is clean. I'd rather be a day slower than wrong.

5Guardrails — don't do this

Never quote a single-month NP number in a doctor conversation. Use a 3- or 6-month rolling average. Single months lie, especially in practices under 40 NPs/month.
Do not recommend increasing OR pausing marketing spend off a single reading. Widen the window, check lead time, then talk to Paul or Amy before anything goes to the doctor.
Do not use NP data on a closed, divested, or transitioning practice as if it's operational. Check practice status FIRST — comparing a structural change to itself is the fastest way to blow your credibility.
Do not walk into a case-acceptance conversation with the doctor without ROD sign-off. NP Case Acceptance % is a clinical/production conversation, not an MM-owned one — you can surface the number, you don't own the recommendation yet.
Do not screenshot or share this data outside SGA. Internal only. If you need to reference it, describe what you saw.

6Common misreads

TrapNew Patients down 8% one month = 'marketing is failing.'

Why it's wrongOne-month NP swings are almost always noise, especially at practices under 40 NPs/month. Pull the 3-month rolling and the same-window YoY before you draw any conclusion. If the 3-month is flat and one month dipped, that's a schedule or holiday artifact, not a marketing signal.

TrapNew Patients are flat, so 'we don't have a new patient problem.'

Why it's wrongFlat NPs with Net Patient Gain negative means the back door is open — active patients are dropping off recall and you're using NPs to plug the hole. That's a retention problem the OM owns, not a marketing win.

Trap'Online scheduling isn't working — we barely get any.'

Why it's wrongDI Online-Scheduled NPs at zero doesn't mean patients don't want it — it usually means the CTA is buried on the website, the GBP appointment link is missing, or front desk is talking people out of it on the phone. Check the digital storefront before you blame the channel.

Trap'Case acceptance is down because the leads are worse.'

Why it's wrongNetwork-wide, Presented $ is up ~2.4% and Accepted $ is down ~10%. Same patient pool, same demographics — patients are saying no more often, not showing up worse. That's a treatment-planning and financial-conversation problem, not an NP-quality problem.

7Next step when you find the signal

If you find the signal, write it up in one paragraph — practice, metric, window, what it says, and what it does NOT say — and drop it to Paul and Amy before anything goes to the doctor or the ROD. If it's a lead-time or scheduling-template issue, loop in the ROD so it's their conversation, not yours. If it's a retention/Net Patient Gain issue, loop the OM through the ROD. If it's genuinely an acquisition gap AND the practice can absorb more NPs (lead time under a week, NP no-show under practice average), then it earns a spot on the Marketing Tasks Smartsheet as a candidate for spend — and it goes on the next ROD meeting agenda for sign-off before anything moves. If a number looks wrong at any point, ticket to sam@incline / manual@incline and confirm before you take it into the room.

?Practice questions — can you actually do this?

Week 4 — Thursday 7/31

Schedules & Capacity — Lead Time, Provider Days, and the "You Need a Hygienist, Not Ads" Moment

This is the week you earn your seat at the ROD table. Before you spend a marketing dollar or greenlight a promo, you need to be able to look at lead time and provider days and know whether the practice has a demand problem or a capacity problem — because 8 times out of 10 it's capacity. If you walk out of this session able to say "hygiene is booked 26 days out, don't touch marketing until we fix staffing," you've already changed how these conversations go.

1Conversation this answers

Said in the roomWe need more new patients — the schedule feels empty.

What they actually meanChairs look open to them right now. They're assuming the phone isn't ringing enough.

What the data provesIf Doctor Lead Time is 3-4+ weeks, patients ARE calling — they just can't get in fast enough. That's a template/capacity conversation, not a marketing conversation. If lead time is genuinely short AND Visits per Provider Day is low, then and only then look at new-patient flow.

Said in the roomMarketing isn't working — we spent the money, the chairs still feel empty.

What they actually meanThey want to know why the spend didn't show up in the schedule.

What the data provesPull Provider Days Worked (actual vs budgeted). If the doctor or hygienist only worked 60% of budgeted days, no amount of marketing can fill chairs that aren't staffed. The marketing may have delivered — the practice couldn't catch it.

Said in the roomWe need another hygienist — we're maxed out.

What they actually meanHygiene feels chaotic and booked. They're pre-selling you on a hire.

What the data provesHygiene Lead Time + Hygienist Days Worked together. If lead time is 3+ weeks AND days worked is at budget, they're right — advocate for the hire. If lead time is 3+ weeks BUT days worked is low, it's a scheduling/coverage problem, not a headcount problem.

Said in the roomWe're too busy, we can't take on any more patients.

What they actually meanThe day feels frantic and full.

What the data provesBroken Appointment % + No-Show % + Cancelled %. If broken is 15%+ or trending up double-digits YoY, they're not busy — they're leaky. That capacity is showing as 'full' on the schedule and empty in the chair.

2Metrics to pull

Hygiene Lead Time (working days)

Window: 3-month rolling average — single days lie

Why it mattersThis is Paul's headline metric. It tells you whether the practice has a hygiene demand problem, a capacity problem, or a staffing problem — before you spend a dollar on marketing.

Good looks like10-15 working days out. Patients can get in within 3 weeks.

Bad looks like25+ working days. At 37 days you don't need a marketing budget, you need a hygienist.

Doctor Lead Time (working days)

Window: 3-month rolling

Why it mattersPaired with hygiene lead time it tells you the story. Short doctor lead time + long hygiene lead time = template/coverage problem. Long doctor lead time = restorative capacity problem or template problem.

Good looks like5-10 working days for restorative.

Bad looks like15+ working days, or under 3 days combined with low Visits per Provider Day (empty schedule, not efficient schedule).

Provider Days Worked (actual vs budgeted)

Window: 3-month, compared to same 3-month YoY

Why it mattersThis is where 'the schedule feels empty' usually gets solved. If the doctor is only in 3 days a week when budget says 4, the chairs are empty because nobody is in them.

Good looks likeActual within 90-100% of budget.

Bad looks likeActual under 80% of budget — no marketing spend can fix this.

Broken Appointment %

Window: 3-month, plus YoY comparison

Why it mattersNetwork-wide broken appointments are up 27% YoY. This is the leaky-bucket metric. Fix this before you spend on new-patient acquisition.

Good looks likeUnder 8%.

Bad looks like12%+ or trending up 3+ points YoY. That's PeerLogic/confirmation-call work, not marketing work.

No-Show %

Window: 3-month, plus YoY

Why it mattersNo-shows are up 37% YoY network-wide. Same story as broken — capacity being wasted on empty chairs.

Good looks likeUnder 5%.

Bad looks like8%+ or a clear upward trend. Deposits, confirmations, and cancellation policy conversation, not a marketing conversation.

Cancelled Appointment %

Window: 3-month, plus YoY

Why it mattersDifferent from broken — cancelled means they told you. Rising cancels + rising broken = the whole schedule integrity story is falling apart.

Good looks likeUnder 8% with same-week rebook.

Bad looks likeOver 12% without a rebook workflow. Front desk conversation.

Visits per Provider Day

Window: 3-month rolling, YoY comparison

Why it mattersThe sanity check on lead time. Short lead time can mean 'efficient' or 'empty' — this metric tells you which. Also flags front-desk scheduling problems when Days Worked is high but Visits per Day is low.

Good looks likeIn line with practice historical average and RODs benchmark for that specialty.

Bad looks likeDeclining trend even when Provider Days Worked is stable — chairs open when the doctor is there.

3How to read it

Start in the ROD Dashboard, not the individual practice dashboards. Filter Legacy Company to Gen 4 (or SGA), Specialty to General Dentistry, and set your window to 3-month or 6-month averages — never a single month, single months lie. Look at Hygiene Lead Time FIRST. If it's over 3 weeks, stop reading, that IS the conversation. If lead times look clean, move to Provider Days Worked (actual vs budgeted) — this is where 'the schedule feels empty' usually gets explained. Then check Broken/No-Show/Cancelled trends YoY — if those are climbing, the practice has a schedule integrity problem, not a marketing problem. Only after all three of those look healthy do you pull Visits per Provider Day and start asking whether it's actually a production or new-patient issue (that's next week's module). If any number looks impossible — hygiene lead time of 0, or Provider Days Worked at 200% — don't argue with it in the room, submit an incline ticket and confirm before the next meeting.

4Talk track — say it like this

Before we talk about marketing spend — can we look at how far out you're scheduling? If hygiene's booked three weeks out, no ad is going to help that.
Your hygiene lead time is 37 days on a 3-month average. You don't need a marketing budget, you need a hygienist. Let me take this to the ROD.
Doc, your lead time is 8 days but hygiene is 26 — that tells me it's a scheduling template problem, not a demand problem. Can we get Alex Megan on this before we do anything on marketing?
Broken appointments are up 27% YoY here. If we fix that before we spend on new-patient marketing, you're going to feel it in the schedule inside of a month — and it costs nothing.
Provider Days Worked is at 62% of budget this quarter. The chairs aren't empty because the phone isn't ringing — they're empty because nobody's in them. That's a staffing conversation, not a marketing one.
I want to be careful here — this could be a lead-time problem, a schedule-integrity problem, or an actual new-patient problem, and they get solved three different ways. Let me widen the window to 6 months and come back to you before ROD.

5Guardrails — don't do this

Do NOT recommend 'hire a hygienist' or 'cut the marketing spend' in the doctor's chair. Bring the data to the ROD first — those are P&L decisions, not MM calls.
Never read a single-month lead time. 3-month or 6-month rolling averages only. A hygienist taking two weeks off will make one month look like a crisis that isn't there.
Check practice status BEFORE flagging bad numbers. A transitioning, divested, or recently-acquired practice will look terrible on lead time and Provider Days Worked — that's a structural artifact, not an operational failure.
If a number looks impossible (hygiene lead time of 0, Provider Days Worked at 150%, no-show at 40%) don't argue with the doctor about it — submit an incline ticket to sam@incline / manual@incline and confirm before the next conversation.
First three or four times you take this data doctor-facing, Paul or Amy is in the loop. You are LEARNING to read these dashboards, you are not replacing the ROD.

6Common misreads

Trap'Doctor lead time is 3 days, we're in great shape.'

Why it's wrongShort lead time can mean efficient — or it can mean the schedule is empty. Always cross-check with Visits per Provider Day and Provider Days Worked. A 3-day lead time with declining visits per day is a bleeding practice, not a healthy one.

Trap'Hygiene lead time dropped from 30 days to 15 days — we solved it.'

Why it's wrongIt could also mean a hygienist just left and half the schedule cleared out overnight. Look at Provider Days Worked in the same window before you celebrate. If days worked dropped too, the lead time got 'better' for the wrong reason.

Trap'Broken is only 8% — that's fine.'

Why it's wrongThe absolute number matters less than the trend. 8% climbing 2 points a month becomes 15% by end of quarter. Always pull YoY comparison, not just the current-month value.

Trap'Provider Days Worked is at budget — we're at capacity.'

Why it's wrongDays Worked at budget with Visits per Provider Day trending down means the doctor is IN the office but chairs are still open — that's a front-desk/scheduling problem, not a capacity problem. Marketing won't help that either; a template review will.

7Next step when you find the signal

If hygiene lead time is 3+ weeks on a 3-month rolling: escalate to Paul and the ROD before the next ROD meeting. Do NOT recommend marketing spend, promos, or paid campaigns until staffing/capacity is addressed — that's the trap Paul is trying to keep us out of. If doctor lead time is long but hygiene is healthy: ask the ROD to bring Alex Megan in for a scheduling template review. If lead times are clean but broken/no-show/cancelled is climbing YoY: log it on the Marketing Tasks Smartsheet as a schedule-integrity workstream (PeerLogic confirmation calls, deposit policy, front-desk workflow) — NOT as a marketing spend request. If everything looks clean and production is still flat, park it for next week's Production module — that's where the case-acceptance and value-per-visit story lives.

?Practice questions — can you actually do this?

Week 5 — Thursday 8/7

Production, P&L, and Pacing — answering "we need better patients" with real numbers

"This is the week you stop losing the \"we need better patients\" conversation. When a doctor says that, they don't actually want different humans in the chair — they want more dollars per visit. Power BI can tell you in about ten minutes whether that's a real case-mix problem, a case-acceptance problem, or the doctor feeling anxious about one bad month. By the end of this session you'll be able to walk into a room and say \"your patients ARE saying yes to smaller cases — here's what's actually shrinking\" instead of nodding and promising a marketing push."

1Conversation this answers

Said in the room"We need better patients. The insurance patients are killing us."

What they actually meanDoctor wants a richer case mix — implants, veneers, larger restorative cases. He's not really asking for different humans, he's asking for different dollars per visit.

What the data provesAverage $ per Restorative Exam YoY, Procedural Mix YoY by provider (implants, crowns, prosthodontics), and Accepted $ trend. If restorative avg is flat but Accepted $ is down, the mix is fine and case yes-rate is the problem. If procedural mix has shifted away from high-value codes, that's a clinical/ROD conversation.

Said in the room"Production is way down this month."

What they actually meanHe's looking at one number on one report on one day. He may be right, he may be reading a bad slice.

What the data provesNet Production trend across current month, next month, next+1. If future months are filling faster than current is completing, the practice is actually pacing UP — they just haven't realized the revenue yet. That's the Paul "realize production sooner" story and it changes the whole conversation.

Said in the room"We're presenting all this treatment and nobody's saying yes."

What they actually meanHe feels like the front is losing cases at checkout, or the treatment presentation is falling apart.

What the data provesPresented $ vs Accepted $ (case yes-rate in dollars), NP Case Acceptance %, and Avg $ per Restorative Exam. If Presented is up and Accepted is down, that's a case-presentation / financial-arrangement problem. Marketing can't fix it — the OM and the treatment coordinator can.

Said in the room"Kyle used to do implants and now he doesn't." (or any "Dr. X stopped doing Y" version)

What they actually meanSomething clinical or personal shifted. Maybe skill drift, maybe confidence, maybe the OM stopped scheduling them. Somebody needs to name it.

What the data provesProvider Detail → filter provider to implants (or veneers, or crowns) → YoY. If implant procedures went from 12/month to 2/month, you don't have to argue about it — the report says it. THAT is when you loop the ROD in.

2Metrics to pull

Net Production trend — current month / next month / next+1

Window: 3 months rolling forward, compared to same window YoY

Why it mattersThis is Paul's "realize production sooner" lever. If future months are filling faster than the current month is completing, the practice is pacing up even if this month's number looks flat. It reframes "production is down" into "production is shifting right."

Good looks likeCurrent month tracking to plan, next month +5-10% over current, next+1 continuing to build

Bad looks likeCurrent month soft AND next two months soft or empty — that's a real demand or scheduling problem, not noise

Presented $ vs Accepted $ (Case Acceptance in dollars)

Window: 3-month and 6-month YoY

Why it mattersThis is THE Q2 finding for the whole network: Presented +2.4%, Accepted -10%. Patients are showing up and hearing the plan, they just aren't saying yes to it. This is where "we need better patients" almost always actually lives.

Good looks likeAccepted $ tracking within a few points of Presented $ growth; case yes-rate flat or improving YoY

Bad looks likePresented flat or up, Accepted down 8-15% YoY. That gap is the problem — and it's a treatment-presentation / financial-arrangement fix, not a marketing fix

Average $ per Restorative Exam

Window: YoY, 6-month rolling

Why it mattersCleanest read on case mix. If this is dropping, the doctor is either presenting smaller cases or the higher-value codes are quietly disappearing. Tells you whether "better patients" is a real signal or a feeling.

Good looks likeFlat or trending up YoY; consistent with prior 12-month baseline

Bad looks likeDown 10%+ YoY with no obvious associate turnover or fee-schedule change — that's a case-mix erosion story

Procedural Mix YoY by provider (implants, crowns, prosthodontics, ortho)

Window: YoY, and 12-month rolling to smooth seasonality

Why it mattersThis is where cosmetic-competency and "Dr. X stopped doing Y" get answered. You don't have to argue about it — you pull Provider Detail, click the name, filter the category, and the YoY number is the number.

Good looks likeHigh-value categories flat or growing per provider YoY

Bad looks likeA provider's implant or veneer count drops 60-80% YoY with no obvious reason (leave, associate change, scope shift)

Production per Provider Day

Window: 3-month average, YoY

Why it mattersCorrects for schedule size. A doctor working 12 days a month at $15K/day is a totally different story than one working 20 days a month at $9K/day, even if the monthly total is the same. Helps you tell a productivity story instead of a volume story.

Good looks likeStable or improving YoY; consistent with practice's own baseline

Bad looks likeDropping 10%+ YoY while Provider Days Worked is flat — that's an operatory-mix, scheduling-template, or case-mix issue

Presented per Completed Appointment (case per visit)

Window: 3-month rolling

Why it mattersTells you whether the doctor is finding treatment during visits. If visits are up but Presented $ is flat, the exam or the hand-off to the TC is where the leak is.

Good looks likeRising or steady as completed appointments rise

Bad looks likeFlat or falling while completed appointments rise — the doctor is seeing patients but not diagnosing or presenting

3How to read it

"Start on the ROD Dashboard, not a practice-level dashboard. Filter Legacy Company to Gen 4 (or SGA) and Specialty to General Dentistry so you're comparing apples to apples. First thing you look at is Net Production trend across current month, next month, and next+1 — that's your pacing read, and Paul cares about it more than the raw number. Second, put Presented $ next to Accepted $ and eyeball the gap; if Accepted is dropping faster than Presented, that's a case-acceptance conversation, not a marketing one. Third, only after you've seen the trend and the gap, drop into Provider Hygiene Report → Provider Detail, click the doctor's name, filter to a procedure category (implants, crowns, prosthodontics for veneers) and look YoY. Widen every window to at least 3 months — single months lie, especially in small practices. If something looks off by an order of magnitude, don't rebuild your story around it — verify with an incline ticket before you take it to the room."

4Talk track — say it like this

"Before we talk about spend, can we look at three numbers together? Net Production this month, next month, and the month after. If those are climbing, we're not losing — we're just realizing the revenue a little later."
"The network story right now is patients are showing up and hearing the plan, they're just not saying yes in dollars. Let's see if that's what's happening here before we assume it's a lead problem."
"Doctor, when you say better patients, do you mean bigger cases per visit? Because I can pull average dollars per restorative exam YoY in about two minutes and we'll know if the mix is actually shrinking or if it just feels that way."
"Can I show you what Provider Detail says about your implant volume this year vs last year? I'm not trying to put you on the spot — I want to make sure if we're going to run a campaign, we're pointing it at something the schedule can actually hold."
"OM, help me read this — Presented is up 3%, Accepted is down 9%. That's not marketing. That gap lives between the exam and the checkout. Where do you think we're losing them?"
"Let me pull this fresh and come back Thursday. I'd rather give you the right number in two days than the wrong one right now."

5Guardrails — don't do this

Do not walk into a doctor conversation with procedural mix numbers without the ROD in the loop. That's a clinical conversation. Your job is to surface the signal, not to coach the doctor on what codes to do.
Never recommend "more marketing" from a single-month Net Production dip. Widen the window to 3 or 6 months first, then check pacing on future months. Paul's line: the trend is the truth, the month is the noise.
Don't call out an individual provider (Kyle, Trish, anyone) by name in a group room based on a Provider Detail read. Bring it to the ROD privately first. This data is internal and provider-specific reads are sensitive.
If Presented $ and Accepted $ don't match what the doctor is telling you they're seeing, don't argue in the room. Say you'll pull it fresh and follow up. If the numbers actually look wrong on a second look, submit an incline ticket.
Don't confuse a case-mix problem with a case-acceptance problem. They look similar on the P&L and they have completely different fixes. Presented vs Accepted tells you which one it is.

6Common misreads

Trap"Net Production is down this month, so we have a demand problem — we need more marketing."

Why it's wrongOne month is noise, especially in a smaller practice. Paul's rule: widen to 3 or 6 months. And check the pacing on next month and the month after — if those are filling, this month's dip is a completion problem, not a demand problem. Recommending marketing spend off a single-month reading is exactly the freelancing Amy told you not to do.

Trap"Presented $ is up, so case acceptance is fine."

Why it's wrongPresented $ going up means the doctor is finding treatment. It says nothing about whether patients are saying yes. The whole Q2 network story is Presented up 2.4% and Accepted down 10% — you have to compare the two, not read Presented alone. If you only look at Presented, you'll miss the actual problem and blame the wrong lever.

Trap"Average $ per Restorative Exam is flat, so the doctor is fine on cosmetic."

Why it's wrongRestorative average is a blended number. A doctor can hold the average flat by doing more crowns and zero veneers, or more single-tooth implants and zero full-arch. If the question is specifically cosmetic or specifically implants, you have to go into Provider Detail and filter to that category YoY. The blended number will hide it.

Trap"Production per Provider Day is down, so the doctor slowed down."

Why it's wrongCould be. Could also be a fee-schedule change, an associate leaving, a shift toward more hygiene days, or an operatory being down. Before you take a productivity read into a doctor conversation, check Provider Days Worked, associate roster, and whether the practice is structural (transitioning, closed op, etc). Paul's rule: structural before operational.

7Next step when you find the signal

"If you find a real pacing or case-mix signal, don't take it into a doctor conversation cold. Send Paul (and Amy) a one-paragraph read: what practice, which metric moved, which window, and what you think it means. If it's a provider-specific procedural drop (the Kyle-at-Beaumont pattern), that goes to the ROD first — never straight to the doctor. If it's a case-acceptance dollars gap, loop the OM and the ROD together and put it on the next ROD meeting agenda. Add the practice to Marketing Tasks with a clear note that this is a production/case-acceptance flag, NOT a lead-gen ask, so we don't accidentally chase it with paid media."

?Practice questions — can you actually do this?

Week 6 — Thursday 8/14

Budgets — miss vs make, and what "off budget" actually means

Every budget miss looks like the same emergency until you take it apart. This week you're going to learn to stop reading the variance as one number and start reading it as three: did we work the days we planned, did we produce what we should have per day, and was the budget itself even realistic. After this session you'll be able to walk into a room where a doctor says 'we're behind budget again' and know within five minutes whether it's a staffing story, a case-acceptance story, or a budget-assumption story — not a marketing story.

1Conversation this answers

Said in the roomWe missed budget again. What's marketing doing about it?

What they actually meanSomebody told them the number is red and they want to know who's on the hook. They usually don't know whether the miss came from fewer days, lower per-day production, a bad payer month, or a budget that was never realistic to begin with.

What the data provesCompare Budgeted Provider Days to Actual Provider Days, then Actual Net Production to Budgeted Net Production. If days are down and per-day is flat, it's a schedule/coverage story. If days are up and per-day is down, it's a case-mix or acceptance story. Either way, it's usually not marketing.

Said in the roomWe're down $50K vs last year — the market must be soft.

What they actually meanThey're reading a Net Production variance without checking what changed inside the practice — days worked, provider roster, hygiene coverage, or whether last year had a one-time bump.

What the data provesPull a 3-month or 6-month rolling view of Net Production, Provider Days Worked, and Production per Provider Day. If days are down and per-day is flat, the market isn't soft — you lost capacity. If per-day is down, that's a case-acceptance or hygiene-reappointment conversation, not a market conversation.

Said in the roomCorporate set our budget too high — that's why we're missing.

What they actually meanSometimes true, sometimes a deflection. The honest answer usually lives in the assumption baked into the budget — a new op, a new doctor, an added hygiene day — that didn't happen on time.

What the data provesLook at Budgeted Provider Days vs Actual. If the budget assumed 44 provider days a month and you're running 36, the budget wasn't wrong — the plan didn't happen. That's a very different follow-up than 'the budget was bad.'

Said in the roomWe beat budget last month, we're fine.

What they actually meanOne good month with a big case or a low-budget baseline. Doesn't tell you if the trend is real.

What the data provesRoll it out to 3 and 6 months. Check whether Production per Provider Day is actually up or whether the win came from one implant case. A single month beating budget can hide a declining per-day trend.

2Metrics to pull

Budgeted Provider Days vs Actual Provider Days

Window: 3-month rolling, also check 6-month

Why it mattersThis is the first question, not the last. If you didn't work the days you planned to work, of course production is short. Days-worked shortfall is a schedule, staffing, or PTO problem — it's fixable, but not with marketing.

Good looks likeActual Provider Days within 5% of Budgeted Provider Days across a rolling 3 months

Bad looks likeActual Provider Days 15%+ below Budget for two months running — that's a hygienist you don't have or a doctor day you're not covering

Actual Net Production vs Budgeted Net Production

Window: 3-month and 6-month rolling

Why it mattersThis is the number everyone's staring at, but it's the LAST thing you interpret — after days worked and after structural carve-outs. Only meaningful on a rolling window.

Good looks likeActual within 3% of Budget on a 3-month rolling basis, or above budget with days worked in line

Bad looks likeActual $50K+ below Budget for 3 months with days worked also down — that's not a marketing story, that's a coverage story

Production per Provider Day

Window: 3-month rolling with YoY comparison

Why it mattersThis is the honest read on whether the practice is running well. If days are flat and per-day is down, the doctor's chair isn't full or case acceptance dropped. If days are down and per-day is up, you have a capacity problem, not a performance problem.

Good looks likePer-day trending flat or up YoY on a 3-month rolling basis

Bad looks likePer-day down 10%+ YoY with days worked holding — usually means case acceptance or hygiene reappointment is slipping upstream

Budget Variance $ and Budget Variance %

Window: 3-month rolling, also YoY quarter view

Why it mattersThe headline number. Useful once you've already answered days-vs-per-day and carved out structural. Don't lead with this — end with it.

Good looks likeVariance within +/- 5% on a 3-month rolling basis after structural carve-outs

Bad looks likeVariance -10%+ for 3 months and the assumption baked into the budget (new op, new doctor, added hygiene day) didn't happen

Practice status flag (structural check)

Window: Point-in-time check before you open the variance

Why it mattersBefore you look at any variance, know whether the practice was divested, closed, or is transitioning. A divested practice against its old budget is a math trap. Q2 26 network was down ~1% vs Q2 25 and most of that was structural — the operating practices were roughly flat.

Good looks likePractice is in the current same-store set with no ownership or brand transition inside the compare period

Bad looks likePractice divested mid-year, closed, or transitioning brands — but still being compared to its old-year self

Budget assumption check (new op, new doctor, added hygiene day)

Window: Year-to-date against the original plan

Why it mattersMost annual budgets assume something changes — a new op opens, a doctor starts, a hygiene day gets added. If the assumption didn't land, the variance is a plan-execution story, not a practice-performance story.

Good looks likeAssumption happened on schedule and the ramp matches the plan

Bad looks likeBudget assumed a new doctor starting in April, doctor started in August — the practice looks 'behind' but is actually on plan given what actually happened

3How to read it

Start on the ROD Dashboard, filter Legacy Company to Gen 4 (or SGA), and Specialty to General Dentistry so you're comparing apples to apples. First thing you look at is Budgeted Provider Days vs Actual Provider Days — not the dollar variance. Days first, dollars second. Then look at Actual Net Production vs Budgeted Net Production on a 3-month rolling view, never a single month. Now break the variance into two parts in your head: was it days or was it per-day? If days are down and per-day held, you had a coverage problem. If days held and per-day dropped, drop into Provider Hygiene Report and Provider Detail to see whose per-day fell and in what procedure category. Widen to Go Grow's 18-month rolling window when the doctor pushes on 'we're just having a bad year' — that view will tell you if the trend is real or if you're comparing to a one-time high. Before you quote any of this to the practice, check the practice status: closed, divested, transitioning, or a budget that assumed something that never happened. If any of those are true, the variance number is not the story.

4Talk track — say it like this

'Before we look at the miss, I want to check one thing — how many provider days did we actually work vs what the budget assumed? Because if the days aren't there, the dollars can't be there either, and that's a different conversation than a demand problem.'
'I want to widen this out to a rolling 3 months before we call it a trend. One month can swing $30-50K on a holiday or a vacation and tell us nothing.'
'When this budget was set back in January, what was it assuming — a new op, a new doctor, an added hygiene day? Let's see if that assumption actually landed before we call this a miss.'
'Days worked are up, production per day is down — that tells me the chairs are open but the cases aren't landing the way they used to. Let's look at Presented vs Accepted before we talk about anything else.'
'This practice went through a transition inside the compare period, so the variance number isn't a fair read. Let me pull the operating months only and come back with a cleaner picture before we talk next steps.'
'I don't want to freelance a marketing recommendation off one month of variance. Let me pull the 3-month rolling view and the days-worked trend and come back with a story that actually holds up.'

5Guardrails — don't do this

Don't quote a budget miss to a doctor or OM off a single month — widen to 3 or 6 months first. A holiday week or a doctor vacation can move a monthly variance $30-50K and mean nothing.
Structural before operational — always. If a practice was divested, closed, or is transitioning, its budget was set under different assumptions. Carve it out of any same-store or network comparison before you say a number out loud. Emporia, Park Place SF, Tempe = divested. Spinnaker Hinesville = transition.
Check whether the budget assumption happened before you blame the practice. If the budget assumed a new op or a new doctor and neither showed up, the variance is a math problem, not a performance problem.
Don't freelance a 'we need to cut marketing' or 'we need to spend more on marketing' recommendation off a budget variance. Marketing spend is not the first lever on a budget miss — days worked, per-day production, and case acceptance are.
Don't share budget variance screenshots outside SGA — this is internal financial data. Talk about the shape of the story in the room, don't hand over the picture.

6Common misreads

TrapReading budget variance as a marketing problem

Why it's wrongNine times out of ten a budget miss is a days-worked, provider-mix, or structural problem. Marketing spend is the last lever, not the first. If days worked dropped and production per day held, you had a schedule/staffing issue, not a demand issue.

TrapComparing a divested or transitioning practice to itself and calling the drop a 'miss'

Why it's wrongEmporia, Park Place SF, and Tempe are gone. Spinnaker Hinesville is transitioning. Their budgets were set when they were still fully ours. Leaving them in the comparable set makes the whole network look worse than it is. Carve them out before you quote anyone a number.

TrapAssuming the budget was realistic

Why it's wrongMost annual budgets bake in an assumption — a new op opening in March, a doctor starting in May, a hygiene day added in Q2. If the assumption didn't happen, the variance is a math artifact, not a performance problem. Check the assumption first.

TrapQuoting a single-month budget miss to a doctor

Why it's wrongOne slow month with a holiday, a doctor vacation, or a broken chair will blow the variance and mean nothing. Widen the window to 3 or 6 months before you say the word 'behind' in a room with a doctor.

7Next step when you find the signal

Before you take a budget miss into a doctor/OM conversation, run it past Paul or Amy the first two or three times so you're calibrated on the story. If the miss is structural (divested, closed, transitioning, or the budget assumption never happened), stop — that's an SLT/finance conversation, not a practice conversation, and you should surface it to the ROD, not the doctor. If the miss is operational and tied to days worked, loop in the ROD and the OM on schedule template and provider coverage. If it's operational and tied to per-day production, add it to the Marketing Tasks Smartsheet as a Provider Detail follow-up so it hits the next ROD meeting with actual procedure-category data behind it. If the data itself looks off — variance doesn't match what you know about the practice — submit a ticket to sam@incline or manual@incline BEFORE the next conversation. Never argue the number with the doctor.

?Practice questions — can you actually do this?

Week 7 — Thursday 8/21

Referral Lab Data — Cosmetic Competency, Specialty-to-GP, and Where "We Need Cosmetic Cases" Really Gets Answered

This is the week you stop taking "we need cosmetic cases" at face value. When a doctor tells you they want more veneers, the answer isn't more marketing — it's opening Provider Detail and looking at what they're actually completing. By the end of this session, you'll be able to walk into a room with a GP who thinks she's a cosmetic dentist, or a periodontist who thinks his GP referrers have dried up, and have the receipts to steer the conversation to what's really going on.

1Conversation this answers

Said in the room"We need more cosmetic cases. Marketing isn't bringing me veneer patients."

What they actually meanThe doctor believes she is a cosmetic dentist and that her chair is empty of high-value cases because leads aren't coming in. She may or may not actually be completing veneers — most GPs who say this are doing a handful a year and referring the rest out, or aren't case-accepting the ones they do present.

What the data provesProvider Detail filtered to this doctor, procedure category = Prosthodontics/Crowns/Cosmetic Restoratives, YoY. If she completed 4 veneers last year and 3 this year, marketing spend won't fix that — it's a case-presentation and clinical-confidence gap. If she's completing 40 and wants 60, that's a real capacity conversation with the ROD.

Said in the room"Our GP referrals are down. The offices aren't sending us anymore."

What they actually meanA specialty office (perio, ortho, OS) is feeling a slowdown and assumes their referring GPs have gone cold or are sending elsewhere. Sometimes true. Sometimes the GPs are sending fewer patients TOTAL because their own new-patient flow dropped.

What the data provesReferral volume in by referring practice, 6-month rolling. You'll see whether it's one or two specific GPs who stopped sending (that's a relationship problem — go visit them) or a broad flatline across the whole referring base (that's a market problem, and the fix is upstream at the GPs).

Said in the room"We're seeing plenty of new patients but production isn't moving."

What they actually meanThe doctor senses a case-mix problem but can't articulate it. New patients are showing up but the chairs aren't producing what they used to.

What the data provesProvider Detail + Unscheduled Active Patient Opportunity ($). If NPs are coming in but restorative and prosthodontic completions are flat, either the doctor isn't presenting the higher-value work, isn't case-accepting it, or is scheduling it out and it's dying on the schedule as unscheduled treatment.

Said in the room"Just send me the cosmetic leads."

What they actually meanThe doctor wants pre-qualified veneer/whitening/Invisalign patients delivered to the schedule.

What the data provesRecaptured Patients + Unscheduled Active Patient Opportunity. Nine times out of ten there's a bigger cosmetic-case bucket sitting inside the existing patient base than any marketing campaign will produce in a quarter. Reactivating an unscheduled active patient who's already had a hygiene visit is a warmer cosmetic lead than a cold Google click.

2Metrics to pull

Procedure category production by provider (Provider Detail — crowns, veneers, prosthodontics, cosmetic restoratives)

Window: 12-month YoY, also look at 6-month rolling

Why it mattersThis is where the cosmetic-competency question actually gets answered. Not what the doctor says she does — what she has actually completed and billed.

Good looks likeYoY trend flat or up on prosthodontics/cosmetic restoratives, with consistent monthly volume (not one big case in March and nothing else).

Bad looks likeDoctor says she's a cosmetic dentist but Provider Detail shows 2-3 veneers completed in the trailing 12 months — that's a clinical-confidence or case-acceptance problem, not a marketing problem.

Referral volume in — by referring practice (specialty offices)

Window: 6-month rolling, compared to prior 6-month

Why it mattersFor perio, ortho, and OS, the primary marketing lever is which GP offices are sending. If the whole GP base has flatlined, the fix is upstream — go visit those GPs, not run more ads.

Good looks likeDiversified referring base with 15+ active referrers, top referrer under 25% of volume, no single-source dependency.

Bad looks likeOne GP was 40% of referrals and dropped to 5%. Or three GPs all flatlined the same month — usually means the specialist stopped visiting them.

Recaptured Patients

Window: 3-month and 6-month

Why it mattersReactivations are cheaper and warmer than net-new NPs. When a doctor says "send me more patients," this is usually the first place to look — you likely have hundreds sitting in the base.

Good looks likeRecaptured trending up month-over-month, especially when NPs are flat or down. Means the front desk is working the list.

Bad looks likeZero or near-zero recaptured while Unscheduled Active is climbing. Nobody's calling the list.

Unscheduled Active Patient Opportunity ($)

Window: 3-month trend, current $ balance

Why it mattersThis is the dollars-on-the-table number. Patients who accepted treatment, walked out, and never got back on the schedule. Almost always includes cosmetic/restorative cases the doctor thinks she doesn't have.

Good looks likeNumber is trending DOWN over 3-month as it gets worked and closed.

Bad looks likeSix-figure bucket that's been sitting flat for a year. Nobody is calling these patients.

Case Acceptance % — Presented $ vs Accepted $ (drilled to procedure category where possible)

Window: 3-month rolling, YoY

Why it mattersTells you if it's a presenting problem (doctor isn't offering the work) or an accepting problem (patients say no). Different problems, different fixes.

Good looks likePresented $ trending up AND acceptance % holding above practice benchmark on restorative/prosthodontic categories.

Bad looks likePresented $ up but Accepted $ falling — the doctor is talking about it but not closing it. That's a case-presentation coaching conversation, not a marketing spend.

New Patient Case Acceptance %

Window: 3-month and 6-month

Why it mattersIf a doctor is complaining marketing NPs are "low quality," this is the number that tests that claim. High-quality NP flow that isn't case-accepting is a chair-side problem.

Good looks likeNP case acceptance in line with the practice's returning-patient case acceptance.

Bad looks likeNP case acceptance materially below returning — either the NPs really are lower fit (payer-mix / demographic) or the NP visit workflow isn't presenting comprehensive treatment.

Provider Days Worked (for the doctor in question)

Window: 3-month and YoY

Why it mattersBefore you have any cosmetic-volume conversation, know how many days she was actually in the chair. A doctor working 12 days a month and asking for more veneers is a different conversation than one working 20.

Good looks likeConsistent Provider Days Worked month over month, in line with schedule template.

Bad looks likeDoctor Days Worked dropped 20% YoY but she's blaming marketing for lower production. She's not there.

3How to read it

Start in the ROD Dashboard, filter Legacy Company to Gen 4 (or SGA) and Specialty to General Dentistry when the conversation is about a GP; switch to the specialty filter when you're sitting with a perio, ortho, or OS office. First stop is always Provider Hygiene Report — click the doctor's name to open Provider Detail. That's where the cosmetic-competency question lives. Look at the procedure categories (crowns, prosthodontics, restoratives) on a YoY basis, not last month. Second stop is Recaptured Patients and Unscheduled Active Patient Opportunity ($) — before you accept "we need more leads," find out how big the bucket of warm patients sitting inside the base already is. Third, if it's a specialty office, pull referral volume in by referring practice on a 6-month rolling window — a single-month dip is almost never real, but a 6-month flatline from three specific GPs is a road trip you need to take. Widen the window on everything: 3-month minimum, 6-month better. Single-month reads lie. If the numbers don't match what the doctor swears is happening in the chair, you're allowed to say "let me check with Paul before I bring this to the next conversation" — that's the right answer, not making something up.

4Talk track — say it like this

"Before we talk about marketing spend, can we look at Provider Detail for a second? I want to see what you've been completing on the crown and veneer side so we know what we're building on."
"You said cosmetic — let me pull your prosthodontic and restorative categories YoY. If we're growing there we'll build on it. If it's been flat, that changes what we do next."
"I'd rather work the list we already have before we spend on new leads. Can we pull Unscheduled Active Patient Opportunity? If there's fifty grand of accepted treatment sitting there, that's a phone call, not an ad campaign."
"For the specialty side — instead of guessing which GPs went quiet, let me pull referral volume in by referring practice for the last 6 months. That'll tell us who to go visit."
"I don't want to bring this to the doctor until Paul and I have looked at it together — I'm still learning to read these dashboards and I'd rather be right than fast."
"Recaptured Patients is up but new patients are flat — that means the front desk is working, and the marketing question is really about the top of the funnel. Different fix."

5Guardrails — don't do this

Do not walk into a cosmetic-mix conversation with a doctor without the ROD's sign-off. Procedure-mix pushback is a ROD conversation — you are sourcing the data, not delivering the verdict.
Do not screenshot Provider Detail or Referral volume-in reports and share them outside SGA. Referring-practice names are relationship data and internal only.
Do not tell a doctor "you don't do enough veneers" from a single-month Provider Detail read. Pull 12 months and check Provider Days Worked before drawing any conclusion.
Do not confuse referral volume in (the specialty question) with new patients (the GP question). They live in different reports and answer different problems.
If a doctor insists the numbers are wrong, don't argue in the room. Note the specific report + filter, submit an incline ticket, and follow up in the next conversation once it's verified.

6Common misreads

TrapReading last month's Provider Detail and concluding a doctor doesn't do cosmetic work.

Why it's wrongCosmetic and prosthodontic cases are lumpy — a GP can go two months with no veneers and then complete six in a week. Always widen to 6-month rolling and YoY before making a call.

TrapAssuming referral volume in is down because GPs "chose someone else."

Why it's wrongNine times out of ten, referring GPs are sending less because their own NP flow is down, not because they defected. Look at whether it's one referrer or the whole base — very different fixes.

TrapTreating New Patients and Recaptured Patients as the same bucket.

Why it's wrongRecaptures are cheaper, warmer, and already know the practice. When a doctor says "send me patients," the answer is usually reactivate first, acquire second. Marketing spend on top of an unworked recall list is money lit on fire.

TrapTelling a specialist "your GPs stopped referring" when the real story is one anchor GP dropped and skewed the whole number.

Why it's wrongA single dominant referrer can carry 30-40% of specialty volume. When they wobble, the aggregate looks like a base-wide collapse. Always look at referral volume in BY referring practice, not just the total.

7Next step when you find the signal

If Provider Detail shows a doctor who claims to be cosmetic but isn't completing the work, do NOT confront the doctor. Bring it to the ROD first — this is a Trish Takus-shaped conversation and it belongs to them. If Unscheduled Active Patient Opportunity is large and stagnant, that's a task for the OM (work the list) that goes on the Marketing Tasks Smartsheet with a 30-day check-back. If specialty referral volume in shows two or three specific GP referrers who've flatlined, that's a road trip — put it on the ROD meeting agenda and cross-reference with Amy's Referral Growth Engine assets before you go so you walk in with a specific ask, not a "we miss you" visit. If any number in Power BI contradicts what the doctor is describing in the chair, loop Paul (or Amy) before the next doctor-facing conversation — you're still learning to read these, and the cost of being wrong in front of a doctor is higher than the cost of waiting a day.

?Practice questions — can you actually do this?

Week 8 — Thursday 8/28

Capstone — The 30-Minute Quarterly Practice Review You Can Actually Lead

Seven weeks in, you know where the numbers live. This week we stitch them together into one repeatable move: a 30-minute Quarterly Practice Review you can walk into with the ROD, doctor, and Office Manager and actually lead. By the end of today, you should be able to open Power BI cold on any practice, decide in five minutes whether their story is structural or operational, and leave the room with a one-page brief that names one thing marketing owns, one thing operations owns, and one thing you're going to check back on.

1Conversation this answers

Said in the roomEvery quarter it's the same conversation and nothing changes — can you actually tell us what's going on?

What they actually meanThey want a clear read on where the practice is, not another dashboard tour. They want someone to synthesize.

What the data provesA structured 6-part pull (Frame → Volume → Capacity → Value → Retention → Marketing) gives them a story with a beginning, middle, and end instead of a metric buffet.

Said in the roomMarketing isn't working. We need to spend more.

What they actually meanProduction is down and marketing is the easiest lever to point at.

What the data provesVolume + Capacity + Value pulled together show whether the leak is at the top of the funnel (real NP shortage), in the middle (lead time, broken appointments), or at the bottom (case acceptance). Marketing spend only fixes the first one.

Said in the roomSo what do you actually want us to do?

What they actually meanGive me one thing to change on Monday. Don't hand me a 40-metric readout.

What the data provesThe 1-page leave-behind forces you to name one marketing action, one operations action, and one thing to revisit — and that's it. If the data doesn't support a clear action, the honest answer is 'I'm going to widen the window and come back.'

Said in the roomHow is this practice actually doing?

What they actually meanCompared to itself last year, and compared to what a healthy practice looks like.

What the data provesThe Frame step (structural vs operational vs mixed) decides whether YoY is even a fair comparison. A practice mid-transition or with a doctor out on leave is not comparable to itself last year, and saying that out loud is more valuable than any chart.

2Metrics to pull

Practice Status Check (structural vs operational)

Window: Confirm current state, then look back over the full 6-month or YoY window you're about to compare

Why it mattersThis is Step 0. If the practice closed a location, lost a provider, is mid-rebrand, or is transitioning ownership, YoY comparisons are a data trap. You cannot recommend marketing spend against a structural decline. Structural before operational, every time.

Good looks likePractice is fully staffed, no ownership changes, provider roster stable for the full comparison window — YoY is a fair fight

Bad looks likeDoctor out on leave, hygienist quit in March, or the practice is on the divest list — YoY decline is a headline you shouldn't be selling as an operational problem

Volume — Appointments Completed, New Patients, Visits

Window: 3-month average, then 6-month average, then YoY

Why it mattersThis is the 'is there actually a demand problem' question. Nine times out of ten volume is flat or up and the story is downstream.

Good looks likeAppointments Completed flat-to-up on a 3-month average; NPs within 10% of prior year

Bad looks likeNPs down 20%+ YoY on a 6-month average AND Appointments Completed down — that's the rare case where marketing IS the lever

Capacity — Doctor Lead Time + Hygiene Lead Time + Provider Days Worked

Window: 3-month rolling — single weeks lie

Why it mattersPaul's killer signal. If Hygiene Lead Time is 37 days, marketing spend is wasted — the practice needs a hygienist, not a Facebook ad. If Doctor Lead Time is 8 days and Hygiene is 26, that's a schedule-template problem, not a demand problem.

Good looks likeDoctor Lead Time under 5 working days, Hygiene Lead Time under 10, Provider Days Worked steady

Bad looks likeHygiene Lead Time above 21 days, Provider Days Worked dropping without a staffing explanation

Value — Presented $ vs Accepted $, Case Acceptance %, Avg $ per Restorative Exam

Window: YoY on a 3-month rolling average

Why it mattersThis is where the Q2 root-cause work said the real leak lives. Presented up, Accepted down 10% YoY, means the funnel works and the close doesn't. That's a coaching conversation, not a marketing one.

Good looks likeCase Acceptance % stable or improving YoY; Accepted $ tracking Presented $

Bad looks likePresented $ up, Accepted $ down — patients are being told and saying no

Retention — Hygiene Reappointment %, Recaptured Patients, Net Patient Gain

Window: 6-month rolling (NPG rides on the 18-month Go Grow window)

Why it mattersNew Patients answers 'did we get them in the door.' Net Patient Gain answers 'did we keep more than we lost.' A practice can be +344 NPs this month and -443 NPG over 6 months and look flat from the outside. That's a retention problem masquerading as a marketing problem.

Good looks likeHygiene Reappointment above 85%, NPG positive on 6-month rolling, Recaptured Patients trending up

Bad looks likeHygiene Reappointment under 75%, NPG negative for two quarters running — you are pouring patients into a leaky bucket

Broken / No-Show / Cancelled %

Window: 3-month rolling vs same 3 months prior year

Why it mattersSchedule integrity. Q2 showed broken +27%, no-shows +37%, cancelled +15% YoY network-wide. This is the tax on every other number and it's usually invisible until you look.

Good looks likeCombined Broken + No-Show under 10%, trending flat

Bad looks likeCombined above 15% and climbing — every marketing dollar you spend is buying appointments that don't happen

Marketing tie-back — GBP score, PeerLogic call conversion, spend per Provider Day

Window: Rolling 3-month, tied back to the same window on the operational metrics

Why it mattersThis is the last section, not the first. You only earn the marketing conversation once you've cleared the operational ones. If capacity, value, and retention are healthy and NPs are still down, THEN we look at storefront and spend.

Good looks likeGBP score in the green, call conversion above 40%, marketing spend proportional to production capacity

Bad looks likeGBP under-optimized OR call conversion under 25% — you're paying to send leads to a phone nobody answers well

3How to read it

Start every review at the ROD Dashboard, not a specific practice tab — that's the frame. Filter Legacy Company and set Specialty to General Dentistry so you're comparing apples. Then go in order: Frame first (practice status — closed, divested, transitioning, or clean), then Volume, then Capacity (this is where the lead-time numbers live and this is usually where the story is), then Value, then Retention (Go Grow for NPG, NPG Month Summary for the rolling), then Marketing. Do not skip a step because it's boring — the boring ones are where you save yourself from recommending the wrong thing. If any metric looks wrong or contradicts what the OM tells you in the room, don't argue — flag it, and file a ticket to sam or manual at incline before the next meeting. Always widen the window: 3-month first, then 6-month, then YoY. Single-month reads are how MMs get themselves in trouble.

4Talk track — say it like this

Before I show you anything, I want to name what I think this is. Based on the data, this looks like an operational story, not a demand story. Can I walk you through what I'm seeing?
Your new patient number is actually fine on a 6-month average. The number that's not fine is your hygiene lead time — it's sitting at 28 days. Patients can't get on the schedule. Before we talk about spend, can we talk about the schedule?
I pulled Presented dollars versus Accepted dollars for the last quarter. You're presenting more than last year and closing less. That's not a marketing problem. That's a case-acceptance conversation, and I want to loop the ROD in on it.
I want to leave you with one page. One thing marketing owns, one thing the practice owns, one thing I'm going to check back on in 30 days. Everything else we can come back to.
I don't want to guess on this — the number I'm looking at doesn't match what you're telling me. Let me file a ticket to the data team and I'll come back Monday with a clean read.
Honest answer — this is above where I want to freelance. I want to bring Paul into the next one before we make a call on it.

5Guardrails — don't do this

The one-page leave-behind is a summary, not a memo — one marketing action, one operational action, one thing to revisit. If you can't get it to one page, you're not done thinking yet.
Structural before operational. Confirm the practice isn't closed, divested, transitioning, or missing a provider before you frame anything as a YoY decline. That single check will save you from the worst mistake you can make in this seat.
Do not walk into a Quarterly Practice Review and pitch marketing spend from a single-month read. Widen the window to 3 months and 6 months every time, without exception.
Do not use the Value section to push a doctor on procedure mix (implants, veneers, cosmetic) without ROD sign-off. That conversation belongs to the ROD. Your job is to surface the pattern, not prescribe the fix.
Do not share the one-page brief or dashboard screenshots outside the room. This is internal. If the OM asks for a copy, that's fine — this is for the practice team, not for their vendors.

6Common misreads

TrapReading a single month and calling it a trend.

Why it's wrongOne bad month is noise. Paul says it plainly — widen the window. A practice can have a rough July because the doctor took two weeks off, and if you don't check that first you'll write a marketing recommendation against a vacation.

TrapConfusing New Patients with Net Patient Gain.

Why it's wrongThey answer different questions. New Patients tells you if the front of the funnel is working. NPG tells you if you're keeping more than you're losing. A practice can be positive on one and negative on the other, and if you conflate them you'll recommend more marketing when the real problem is retention.

TrapFraming a structural decline as an operational problem.

Why it's wrongIf the practice lost a hygienist in March or is on the divest list, the YoY drop isn't something a marketing lever fixes. Comparing a mid-transition practice to itself last year is a data trap — you'll spend budget against a decline that has nothing to do with demand.

TrapJumping to marketing spend without checking capacity first.

Why it's wrongIf Hygiene Lead Time is 37 days, more leads don't help — they can't get on the schedule. You'll spend money to generate demand the practice can't absorb, and next quarter the same conversation happens again with worse numbers.

7Next step when you find the signal

Finish every review with three moves in this order. First, drop the one-page brief into the practice's row in the Marketing Tasks Smartsheet with a 30-day revisit date — that's your accountability loop. Second, if the review surfaced anything you're not sure about, escalate to Paul before the next practice conversation, not after — a two-sentence Slack that says 'I'm seeing X, planning to recommend Y, want to sanity check before I take it back to the doctor.' Third, if any Power BI number looked wrong or contradicted what the OM told you in the room, file a ticket to sam or manual at incline that same day so it's fixed before your next pull. If the conversation went somewhere you weren't ready for — procedure mix, provider performance, ownership transition — that's a Paul or ROD escalation, not a freelance. Say 'let me come back to you on that' and mean it.

Cross-cutting reference — open any time

The Three Conversations — Decoded

You are going to hear the same three sentences over and over in a room with a doctor and an OM: "we need new patients," "we need better patients," "we need more cosmetic cases." Almost none of those mean what they sound like. This tab is what you pull up on your laptop before you answer — so you don't accidentally sign the practice up for a marketing spend when the real problem is a scheduling template or a hygienist opening.

1Conversation this answers

Said in the roomWe need new patients.

What they actually meanCould be three totally different problems — not enough people walking in the door (acquisition), people walking in once and never coming back (retention), or no room on the schedule to see them (capacity). The doctor and OM almost never know which one it is when they say it.

What the data provesNew Patients/month vs. Net Patient Gain over 6- and 18-month rolling in Go Grow settles acquisition. Hygiene Reappointment % and Recaptured Patients settle retention. Doctor Lead Time + Hygiene Lead Time on the ROD Dashboard settle capacity. If NPs are flat-to-up but NPG is negative, it is a retention leak, not an acquisition problem. If lead times are past two weeks, more leads make it worse, not better.

Said in the roomWe need better patients.

What they actually meanThe doctor is watching production per visit drop and wants higher-dollar cases walking through the door. Nine times out of ten the complaint is really about case mix and case acceptance, not the patient panel itself.

What the data provesProvider Detail filtered to that doctor, YoY on Presented $ vs. Accepted $, plus Case Acceptance % and Avg $ per Restorative Exam. Q2 root cause showed Presented is UP network-wide and Accepted is down 10% YoY — the yes-rate is the real leak. If Presented is climbing and Accepted is falling, the panel is fine, the close is not.

Said in the roomWe need more cosmetic cases — run us a veneer campaign.

What they actually meanThe doctor wants to do veneers and assumes marketing will produce them. The real question is whether the doctor is actually producing crowns/veneers/prosthodontics today, at what volume, and with what case acceptance.

What the data provesProvider Hygiene Report → Provider Detail → click the doctor → filter to prosthodontics, crowns, and cosmetic restoratives, 12-month YoY. If the doctor is producing 2 crowns a month and no prosth, veneer marketing is going to fail — you cannot market a skill that is not there yet. That is a coaching / clinical conversation before it is ever a marketing spend.

2Metrics to pull

Doctor Lead Time (ROD Dashboard)

Window: 3-month rolling average

Why it mattersCleanest tell for capacity vs. demand. If a new patient cannot get in for three weeks, more leads sit in a queue and get frustrated. Marketing spend on top of long lead time is money on fire.

Good looks likeDoctor lead time under 5 working days

Bad looks likeOver 14 working days = capacity problem, not acquisition problem — do not recommend spend

Hygiene Lead Time (ROD Dashboard)

Window: 3-month rolling average

Why it mattersPaul's line: you do not need a marketing budget, you need a hygienist. If hygiene is booked weeks out, retention will crater no matter how many NPs walk in the front door.

Good looks likeUnder 14 days

Bad looks likeOver 21 days = hire a hygienist before you spend a dollar on ads

Hygiene Reappointment %

Window: 3-month, then widen to 6-month for direction

Why it mattersSingle cleanest retention signal in the tool. If NPs are steady but this is falling, patients are coming in once and never coming back — that is a retention problem masquerading as an acquisition problem.

Good looks likeAbove 85%

Bad looks likeUnder 70% = retention hemorrhage, and no marketing budget will outrun it

Net Patient Gain (Go Grow / NPG Month Summary)

Window: 6-month + 18-month rolling

Why it mattersNew Patients alone lie. A practice can be +344 new patients this month and -443 over 6 months and still look flat to the OM. NPG is the only number that tells you if the practice is actually growing.

Good looks likePositive over both 6-month and 18-month rolling

Bad looks likeNegative NPG while New Patients are positive = you are churning through the panel

Presented $ vs. Accepted $ (Case Acceptance)

Window: 3-month rolling + YoY comparison

Why it mattersQ2 root cause: Presented is up, Accepted is down 10% YoY. The doctor's yes-rate is usually the real leak, not the panel. This is what settles the 'better patients' conversation.

Good looks likeAccepted $ within 10% of Presented; case acceptance % above 65%

Bad looks likePresented climbing YoY while Accepted is falling = closing problem, not a patient problem

Provider Detail by Procedure Category YoY

Window: 12-month YoY

Why it mattersOnly honest way to answer the cosmetic question. Filter one provider to prosthodontics / crowns / restoratives and look at 12-month YoY. Tells you if this doctor is actually a cosmetic doctor or wants to be one.

Good looks likeDoctor has a real running rate in the category with steady or improving case acceptance

Bad looks like1-2 crowns a month and no prosth = doctor is not producing the work today, marketing cannot manufacture it

Broken / No-Show / Cancelled %

Window: 3-month rolling

Why it mattersSchedule integrity is degrading network-wide — broken +27%, no-shows +37%, cancelled +15% YoY. Kills the 'we need more NPs' argument if the practice is not holding the appointments it already books.

Good looks likeCombined under 8%

Bad looks likeCombined over 15% = fix the schedule before you buy a single ad

3How to read it

Start in the ROD Dashboard, not the 45 individual dashboards — filter Legacy Company to Gen 4 or SGA and Specialty to General Dentistry so you are comparing the right practices. Before anything else, check practice status — is this location closed, divested, or transitioning? If yes, stop; YoY on a wind-down practice is a data trap and you will make a bad call. Then always look at 3-month or 6-month averages before you say anything out loud — single-month numbers lie, and Paul will call you on it if you bring a one-month dip to a decision. If the doctor is complaining about case mix or cosmetics, that answer lives in Provider Detail — click the provider name and filter to procedure category, do not try to answer it from the ROD summary. If a number on the dashboard looks flat-out wrong, submit an incline ticket to sam or manual before the next meeting — do not argue with the doctor using data you do not trust.

4Talk track — say it like this

Before we talk marketing spend, can I pull up your lead times? If a new patient cannot get in for two weeks, more leads are going to sit in a queue and get frustrated.
Your new patients are actually flat to up. What I want to look at is whether we are keeping the ones we get — hygiene reappointment is where I would start.
Doctor, when you say 'better patients' — do you mean the case mix, or the case acceptance? Because your presented dollars are up. Your accepted dollars are what I want to dig into with you.
Before we build a veneer campaign, let me pull your last twelve months in Provider Detail. I want to see what you are already producing in prosthodontics and crowns — that tells me where the story starts.
This looks like a schedule problem more than a demand problem — broken and no-show are climbing. Can we get Paul in on the next one so we are looking at this together?
Give me a week — I want to widen the window to three or six months before we make a call. One month can look ugly and be nothing.

5Guardrails — don't do this

Structural before operational — always confirm the practice is not closed, divested, or transitioning before you interpret a YoY decline. Comparing a wind-down practice to itself is the biggest data trap in the tool.
Do not push a doctor on procedural mix — implants, veneers, cosmetic case mix — without ROD sign-off. That is Trish's conversation, not yours. Your job is to surface the data; the ROD drives the clinical push.
Never freelance a 'spend more on marketing' or 'turn off marketing' call from a single-month reading. Widen to 3-month or 6-month before you recommend anything.
Do not share dashboards, screenshots, or numbers outside SGA. This data is internal — no doctor-facing PDFs, no vendor emails, no photos to a group text.
First three or four times you use this in a doctor room, loop Paul or Amy in beforehand. You are learning to read these dashboards, not replacing clinical or production leadership.

6Common misreads

TrapNew patients are down 7% — we need to spend more on marketing.

Why it's wrongQ2 analysis showed the NP decline is real but not the dominant driver of revenue softness. Broken/no-show %, hygiene reappointment, and case acceptance are usually bigger levers. If you recommend spend without checking retention and lead time first, you make the problem more expensive, not smaller.

TrapNet Production is down YoY, so the practice is struggling.

Why it's wrongCheck practice status first — closed/divested/transitioning breaks the comparison entirely. And separate volume from value — completed appointments are usually UP network-wide, but value per visit is down. That is a case-acceptance and case-mix problem, not a demand collapse, and it needs a different fix.

TrapDoctor says he is not seeing cosmetic cases — let's run a veneer campaign.

Why it's wrongPull Provider Detail first. If the doctor produced 2 crowns and zero prosth last quarter, he is not a cosmetic doctor yet. Marketing veneers into a doctor who is not producing them burns the budget and the reputation. That is a clinical/coaching conversation with the ROD before it is ever a marketing spend.

TrapThis month's numbers look terrible — something is wrong.

Why it's wrongSingle-month reads are noisy. Paul's rule is 3-month minimum, 6-month better. And if it still looks wrong after you widen the window, it may actually be wrong — submit an incline ticket to sam or manual before you take it into a doctor meeting, not after.

7Next step when you find the signal

Depends on which conversation you settled. If it is retention or a lead-time / capacity problem, loop the ROD, do NOT recommend marketing spend, and note in the Marketing Tasks Smartsheet that paid media is on hold until scheduling is fixed. If it is case acceptance, that is clinical/coaching — escalate to Paul so he can bring it into the next ROD meeting. If it is a cosmetic gap at the doctor level, do NOT go direct to the doctor — brief the ROD, let them own that conversation with clinical leadership. If the practice is structural (closed, divested, transitioning), flag Amy immediately, do not run YoY analysis for that location, and add a note to the next briefing so nobody else falls into the same trap. Any time the data itself looks wrong, incline ticket first, doctor meeting second.

Reference — pinned tab, use every week

Guardrails, escalation, and the "not your call to make" list

This tab isn't a lesson — it's a leash. Before you take anything you pulled out of Power BI into a room with a doctor, run it against this list. You're learning to read these dashboards, not replacing Paul, the ROD, or the clinical leadership team — and the fastest way to lose credibility in front of a doctor is to walk in with the wrong number or a recommendation that wasn't yours to make.

1Conversation this answers

Said in the roomDoctor: 'I want to grow my veneer/implant/cosmetic case volume — what's marketing going to do about it?'

What they actually meanThe doctor is asking you to weigh in on procedural mix and clinical case type. That is a Paul + ROD conversation, not a Market Manager conversation.

What the data provesYou CAN pull the Provider Detail YoY procedural history to prep for the conversation — but you do not present it or make a recommendation on it without Paul or the ROD in the room.

Said in the roomOffice Manager: 'Turn off the marketing, it's not working — we didn't get new patients last month.'

What they actually meanThey're reading a single month as a trend. It's almost never a single-month decision.

What the data proves3-month and 6-month Net Production, New Patients, and Net Patient Gain will tell you if last month was noise or a real slide. Widen the window before you recommend cutting anything.

Said in the roomDoctor: 'This number in Power BI is wrong. My schedule was not that light.'

What they actually meanEither the number IS wrong (data feed hiccup) or the doctor's memory of last month is smoothing over reality. Both happen.

What the data provesDon't debate it live. File the incline ticket, get confirmation, and come back with the reconciled number. If it was a data error, you're the hero. If it was accurate, you have receipts.

Said in the roomROD: 'New patients are down — do more Google Ads.'

What they actually meanThe ROD is jumping to a lever without ruling out the two levers underneath (retention and case acceptance).

What the data provesPull Hygiene Reappointment %, Broken/No-Show %, and Presented vs Accepted $ before you spend a dollar. If retention or case acceptance is the leak, ads make it worse, not better.

2Metrics to pull

Practice Status Check (structural vs operational)

Window: current status vs the window you're analyzing

Why it mattersComparing a closed, divested, or transitioning practice to itself YoY is a data trap. Top-decline practices are almost always structural. Rule that out FIRST or every downstream conclusion is garbage.

Good looks likePractice is open, staffed, not in transition — YoY comparison is fair game

Bad looks likePractice closed a location, lost a doctor, or changed brands mid-window — you're looking at a shell, not a trend

Window Length Check

Window: 3mo minimum, 6mo preferred, YoY for anything structural

Why it mattersPaul's rule: single months lie. One bad week from a snowstorm, one provider on PTO, one holiday can move the number 15%. Never make a recommendation off a single-month read.

Good looks like3-month rolling and 6-month rolling both show the same direction

Bad looks likeYou're staring at one month and typing an email to the ROD about it

Filter Sanity Check (Legacy Company + Specialty)

Window: n/a — pre-flight check

Why it mattersIf you didn't set Legacy Company (Gen 4 / SGA / MODIS) and Specialty (General Dentistry) you are comparing apples to a fruit salad. Every conversation starts with those two filters set.

Good looks likeLegacy Company set, Specialty set to General Dentistry, comparable practice set locked in

Bad looks likeOrtho and pedo mixed into a GD trend line, or you're looking at total SGA when the doctor asked about a Gen 4 site

New Patients vs Net Patient Gain

Window: NP monthly + NPG 18mo rolling (Go Grow view)

Why it mattersThese are NOT the same metric. New Patients = did we acquire? Net Patient Gain = did we hold on to them? A practice can be +344 NPs this month and -443 over 6 months and still look flat. If you confuse them in a room, you'll recommend the wrong lever.

Good looks likeYou know which question you're answering before you pull the number

Bad looks likeYou quoted New Patients when the doctor was actually asking about retention (or vice versa)

Who's in the room / who signs off

Window: before every doctor-facing meeting

Why it mattersCosmetic-competency, implant, veneer, and procedural-mix conversations belong to Paul and the ROD — not to you. Staffing, capacity, and budget calls belong to the ROD. Marketing spend redirects need Amy. If it's not on your list, escalate before you speak.

Good looks likeYou've pinged Paul/Amy/ROD before the meeting and they're either in the room or briefed

Bad looks likeYou're improvising a case-mix recommendation in front of the doctor because it was in the deck

Marketing Tasks Smartsheet follow-up logged

Window: same day as the conversation

Why it mattersAnything you promise in the room dies in your inbox if it doesn't get a row. Sheet ID 4611937383960452. If you don't log it, it didn't happen.

Good looks likeRow added same day with owner, due date, what you're waiting on, and the practice code

Bad looks likeYou told the doctor you'd 'circle back' and it's still on a sticky note two weeks later

Data Integrity Check (incline ticket threshold)

Window: same day

Why it mattersPaul's rule: if the number looks wrong, it probably is. Don't argue with the doctor live. File the ticket to sam@incline / manual@incline, come back with reconciled data.

Good looks likeYou noticed the discrepancy, filed the ticket, and told the room 'let me confirm and come back Thursday'

Bad looks likeYou defended a number you weren't sure of, or you dropped the discrepancy and kept moving

3How to read it

Read this tab in order every single time — status, window, filters, whose call it is. Practice status first: if the site is closed, divested, or transitioning, most of what you're about to say doesn't apply and you'll embarrass yourself. Then check your window — if you're looking at one month, stop and pull the 3-month and 6-month before you go any further. Then check your filters — Legacy Company and Specialty locked in, comparable set only. Only THEN ask yourself the real question: is this a call I'm authorized to make, or is this a Paul / ROD / Amy conversation? If you're not sure, escalate. The cost of a five-minute Slack to Paul is nothing. The cost of freelancing a "cut the ad spend" recommendation to a doctor and being wrong is your credibility for the next year.

4Talk track — say it like this

Doc, before I bring numbers on veneers or implants, let me get Paul on the phone — that's a procedural-mix conversation and I want him with me so we're aligned. Give me until Thursday.
Hold on — I hear you on turning off the ad spend, but I don't want to kill the wrong thing on one month's data. Let me pull the 3-month and net patient gain and come back to you tomorrow before we pull the plug.
That number looks off to me too. I'm not going to debate it with you live because I want to give you the right answer. I'm filing a ticket to incline right now, and I'll come back with confirmed data by end of week.
Before we go to marketing spend as the answer, I want to look at hygiene reappointment and case acceptance for the last 90 days — if we're losing them after they walk in, more ads makes it worse.
This one's above my pay grade — that's a staffing/capacity call, and it needs to go to the ROD before I build anything on the marketing side. Let me loop them in and we'll come back together.
I want to flag this for Paul before our next ROD meeting. Can we hold the decision until then? I don't want you making the call on a partial read.

5Guardrails — don't do this

Never freelance a procedural-mix / cosmetic / implant / case-type recommendation to a doctor. That is a Paul + ROD conversation. You can prep the data. You do not present the conclusion.
For your first several doctor-facing dashboard conversations, Paul or Amy is in the room (or briefed and on standby). You're learning to read this — not replacing clinical or production leadership.
No screenshots, no exports, no PDFs of Power BI outside SGA. This data is internal. Not to the doctor's spouse, not to the OM's personal email, not to a vendor. Ever.
Never make a 'turn off marketing' OR 'spend more on marketing' call from a single-month reading. Widen the window to 3mo/6mo first, every single time.
If the data looks wrong, file the incline ticket (sam@incline / manual@incline). Don't debate it live, don't defend a number you're not sure of, don't drop it and hope no one noticed.

6Common misreads

TrapReading a single month as a trend

Why it's wrongOne provider on PTO, one snowstorm, one holiday week can swing the number 15%. Paul's rule: single months lie. Always pull the 3-month and 6-month before you form an opinion.

TrapComparing a closed / divested / transitioning practice to itself YoY

Why it's wrongStructural changes make YoY meaningless. Top-decline practices are almost always structural — closed a location, lost a doctor, mid-rebrand. Check practice status BEFORE analyzing. If you skip this step, every recommendation you make on top of it is wrong.

TrapConfusing New Patients with Net Patient Gain

Why it's wrongNew Patients = did we acquire? Net Patient Gain = did we hold on to them? These answer different questions and drive different levers. A practice can post big NP numbers and still be shrinking. Know which one you're quoting before you open your mouth.

TrapAssuming the doctor is wrong when they say the data looks off

Why it's wrongPaul's rule cuts both ways — if it looks wrong, it probably is. Doctors are often right that something is off. File the ticket to incline, don't defend a number you can't back, and come back with confirmed data. Trust is easier to keep than to rebuild.

7Next step when you find the signal

Every escalation gets a row in the Marketing Tasks Smartsheet (sheet ID 4611937383960452) the same day — practice code, what you promised, who owns the next step, and what you're waiting on. Then route it: procedural mix / cosmetic / implant / case type → Paul (with the ROD copied). Scheduling templates, capacity, lead-time fixes, hygienist gap → Alex Megan (with the ROD copied). Staffing decisions, budget, or capacity trade-offs → ROD directly. Marketing spend redirect, GBP or website concern → Amy. Data that looks wrong → incline ticket to sam@incline / manual@incline, and add "waiting on incline" to the Smartsheet row so it doesn't get lost. Bring the reconciled answer (or the escalation status) to the next ROD meeting — don't wait for someone to ask you about it.

What this SOP is (and what it is not)

Metrics we need help finding in Power BI

ROD Dashboard — The Front Door

1Conversation this answers

2Metrics to pull

3How to read it

4Talk track — say it like this

5Guardrails — don't do this

6Common misreads

7Next step when you find the signal

?Practice questions — can you actually do this?

Go Grow — Net Patient Gain and the 18-Month Rolling Window

1Conversation this answers

2Metrics to pull

3How to read it

4Talk track — say it like this

5Guardrails — don't do this

6Common misreads

Live from Paul Real practices, real reads

7Next step when you find the signal

?Practice questions — can you actually do this?

New Patients — Actual Acquisition Data, Not the Vibe

1Conversation this answers

2Metrics to pull

3How to read it

4Talk track — say it like this

5Guardrails — don't do this

6Common misreads

7Next step when you find the signal

?Practice questions — can you actually do this?

Schedules & Capacity — Lead Time, Provider Days, and the "You Need a Hygienist, Not Ads" Moment

1Conversation this answers

2Metrics to pull

3How to read it

4Talk track — say it like this

5Guardrails — don't do this

6Common misreads

7Next step when you find the signal

?Practice questions — can you actually do this?

Production, P&L, and Pacing — answering "we need better patients" with real numbers

1Conversation this answers

2Metrics to pull

3How to read it

4Talk track — say it like this

5Guardrails — don't do this

6Common misreads

7Next step when you find the signal

?Practice questions — can you actually do this?

Budgets — miss vs make, and what "off budget" actually means

1Conversation this answers

2Metrics to pull

3How to read it

4Talk track — say it like this

5Guardrails — don't do this

6Common misreads

7Next step when you find the signal

?Practice questions — can you actually do this?

Referral Lab Data — Cosmetic Competency, Specialty-to-GP, and Where "We Need Cosmetic Cases" Really Gets Answered

1Conversation this answers

2Metrics to pull

3How to read it

4Talk track — say it like this

5Guardrails — don't do this

6Common misreads

7Next step when you find the signal

?Practice questions — can you actually do this?

Capstone — The 30-Minute Quarterly Practice Review You Can Actually Lead

1Conversation this answers

2Metrics to pull

3How to read it

4Talk track — say it like this

5Guardrails — don't do this

6Common misreads

7Next step when you find the signal

The Three Conversations — Decoded

1Conversation this answers

2Metrics to pull

3How to read it

4Talk track — say it like this

5Guardrails — don't do this