In Part 1 of my two-part “How Will I Ramp Up?” series, I introduced the concept of the “balanced flywheel” and how to use it as a framework for planning your ramp-up process as we come out of the shutdown and start to see more patients. In Part 1, I outlined the six areas of the wheel and walked through the first three categories.

I strongly suggest you read that article first, if you haven't already, as it provides the necessary context for what follows. Continuing our clockwise journey on the wheel, this article focused on the additional three areas:

Scheduling template

I have often asked clinicians: when you come into the practice in the morning and take a look at the appointments that are lined up, do you instantly know what kind of day you're about to have?

If it's the kind of day you are dreading, with a long series of low-value routine cases, the question then becomes: why did that happen? It's an important question because the truth is the schedule for that day didn't just happen — it was programmed and appointed by you and the team in the past.

‘RAMP UP' WITH SPEAR ONLINE: Members can take Imtiaz Manji's “How Will I Ramp Up When I Get Back” Part 1 (1.25 CE credits) and Part 2 (1.25 CE credits) courses to go into greater depth on this subject. Part 1 includes a sample Practice Safety Checklist.

Once you recognize that, why not decide to schedule those appointments in a way that makes your days as fulfilling as possible? When you think about it, those “great days” you have had in the past were probably days when you saw fewer patients, but you did more comprehensive cases, so your value for the day was high. Programming days like that is going to become especially important now, when you are in a situation of having to do more with less.

That's the philosophy behind using a scheduling template. For one thing, it gives you a framework for optimizing your time, and the team's time, by having you move from operatory to operatory efficiently, as your clinical assistants handle the beginning and ending of the patient's time in the chair.

Beyond that, though, it ensures that you are seeing the right mix of cases, with the right “rock” appointments, so that you are programmed to meet your safety standards and your revenue goals. It ensures you reserve time for the other essentials in your day, such as team meetings and communication with your interdisciplinary colleagues.

Of course, in this article I can't go into all of the particulars that make up an effective template — but if you aren't using a strategic template to optimize your time, I strongly urge those of you with Spear Online access to view the “Optimizing the Schedule for Practice Growth” course (0.50 CE credits) to see how it can help you take control of your time.

Now as you ramp up your workflow once again, it's time to revisit your template with new realities in mind. This is something you should be doing from time to time anyway. As your goals change, so should your template — but it is especially important now, when you really need to get the most out of the time you have and the cases you see.

Adjusting your template is about taking into account the variables that come into play in this new environment, with most states now open for elective dental procedures. That starts with deciding when to schedule appointments. Based on your jurisdiction, my advice to dentists was to start booking appointments early given the estimates on reopening dates, given the understanding that you may have to reschedule them later.

Many practices have arranged for an especially light schedule upon return, as everyone addressed new protocols. You'll really want to take the time to slow down and make sure everyone — the team and the patients — are feeling comfortable and confident. You can then ramp things up further as you proceed in the coming weeks.

Then there are the other variables to consider, such as your facility capacity versus how many patients you'll be seeing per day, and your team capacity based on the staffing levels you need to serve those patients. These, and other factors, will determine how prepared you are to serve patients, and at what level.

Taking these variables into account, you need to then rework your schedule to set easily achievable progressive goals in ramping up. After that, I suggest coming up with a quarterly goal and then breaking it down into weekly and daily segments, which can be revised as circumstances improve.

If you have been drawing on your reservoir and getting patients appointed, as we discussed in my Part 1 article, you may be able to match — or almost match — pre-crisis production levels fairly quickly with the right strategic scheduling. In any case, you need to be ready to revise and adjust your template as things ramp up.


You'll remember that in Part 1, when I introduced the concept of the flywheel, as described by Jim Collins in “Good to Great,” you were asked to imagine a huge heavy wheel and think about the effort it would take to get it going for the first few turns before momentum took hold.

A vitally important thing to remember about getting that flywheel turning is that you aren't doing it yourself. It requires concentrated teamwork.

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With that in mind, consider each of the categories we have discussed so far from a team perspective. For instance, when it comes to new safety measures, what are you doing to provide additional protection for team members and patients? How are you communicating that to the team? This is very important, because it is only when the team members have clarity for the new procedures and feel safe that they can begin to communicate that to patients.

And of course, many team members will be communicating with patients, even during the lockdown phase, as you go through your “reservoir” to identify and connect with patients so you can get your first four weeks scheduled and your pipeline flowing for the weeks beyond. Getting those patients in the practice, reassuring them about safety, communicating about their needs, and looking for ways to help them get to “yes” is going to require new levels of team effort and alignment.

The category of “calendar” will naturally also have a significant focus on the team, as they will be greatly affected by any changes in practice hours and staffing levels as you ramp up, meaning they will likely need to be more flexible and adaptable in the weeks ahead than they may have been used to.

All of this means spending time with your team now to get them aligned and ready for what is ahead. Continue to hold meetings virtually. Brainstorm new approaches. Discuss implementation and patient communication strategies. Put in the energy, as a team, to getting that flywheel moving.

There may, of course, be some other team issues to deal with, such as team members who are reluctant to return for safety reasons or can only return on a limited basis at first. I can tell you that this is where leadership skills, especially the ability to communicate and be transparent about your objectives, becomes important.

That extends to everything you do with the team right now. If you furloughed most of your staff, some practices have brought team members in for several days before reopening for a “training camp to address changes to daily protocols and the scheduling template.

Economic stability

This is a subject I have covered in some depth in my “An Economic Framework to Make Effective Decisions” article, and it is an important component of your flywheel as you think about your strategies in the short term and long term. Those of you with Spear Online access can take the “Economic Framework” course based on my recent webinar of that same title. Additionally, more detail is available to Spear members in my “How Will I Ramp Up When I Get Back (Part 2)” course (1.25 CE credits).

I suggest Spear members use those resources for a more detailed discussion, but what I want to stress is here is the importance of having an economic recovery plan and letting that plan guide your daily actions.

We all know that full economic recovery for you and the practice won't occur in the first month back. It won't even happen by the end of this year, so don't put yourself in panic mode to catch up. You should, however, be prepared to put in extra hours per week and per month, and to adjust your goals upward as you gain traction.

Overall, any effective vision must take the long view. As I mentioned in Part 1 of this series, a realistic recovery plan should extend to the end of 2021 and it should be reviewed every six months. You should establish revenue goals that you can break down monthly, weekly, and daily — and use those goals to guide you in creating your new scheduling template.

You should be ready to adjust those goals as circumstances change. That's how you can create a road map to getting your practice back to operating at full power. Eventually, if you approach these coming months with the right focus and energy, you could even find yourself exceeding the revenue you produced before the shutdown.

It is often said that the ones who achieve the greatest success in challenging times are not those who are biggest or strongest or who have the greatest resources — it is those who are most adaptable to change. Those are the ones who take a calm, measured approach, with one eye on the present and one eye on the future, with a sure sense of where they are going.

When you look at it that way, these coming months are going to provide a special opportunity for dental practitioners who are ready to seize the moment and relaunch their practice with energy and with confidence.

Take the approach I've outlined here, commit to being flexible and adaptable, while still be unshakeable in pursuing your vision, and you will look back on this crisis as a turning point that inspired you to realize the real power of your abilities.

Imtiaz Manji is co-founder and chairman of Spear Education. Discover more of his practice management and leadership lessons at