Collections are declining...now what?!?

A situation I'm seeing all too often these days.

Collections are down.

2023: $718K

2024: $575K

2025: $536K

If you’re within a few years of selling, that trend matters.

But here’s the good news:

Most revenue declines in dental practices are operational...not market-driven.

Which means they’re fixable.

If I had 6–12 months to quickly right the ship before going to market, here’s where I’d focus:

1️⃣ Hygiene First (Fastest Lever)

Hygiene should be ~30–35% of total collections.

If it’s below that, you likely have recall leakage.

Immediate actions:

• Reactivation campaign to overdue patients

• Tighten recare scheduling before patients leave

• Evaluate hygiene capacity (are columns actually full?)

Hygiene is the easiest way to stabilize revenue quickly.

2️⃣ Production Per Day, Not Just Annual Collections

If the doctor reduced days, the fix isn’t always “work more.”

It’s optimize the days you’re already there.

• Pre-block high-value procedures

• Review treatment plans sitting unscheduled

• Morning huddles focused on production targets

3️⃣ Case Acceptance Audit

Collections often fall because diagnosed treatment isn’t converting.

• Are financial options clearly presented?

• Is someone accountable for follow-up?

• Are large cases getting second conversations?

Small improvements in case acceptance move revenue meaningfully.

4️⃣ Expense Discipline = EBITDA Recovery

Even if collections don’t fully rebound, margin often can.

• Normalize staffing ratios

• Eliminate discretionary spend

• Adjust owner comp properly

Remember: buyers purchase EBITDA ...not gross collections.

5️⃣ Address Real Estate Early (If You Own It)

Set fair market rent.

Clean up lease terms.

Remove ambiguity.

Nothing slows a deal like unclear occupancy structure.

A declining practice isn’t broken.

It’s usually drifting.

And drift can be corrected faster than most owners think, if you act intentionally.

If you’re seeing softness and considering an exit in the next few years, stabilize first.

Even modest improvements can materially change your valuation multiple.

Sound like your situation? Reach out and I'll help you develop an action plan!