About james

This author has not yet filled in any details.
So far james has created 3065 blog entries.

Pre Presentation Team Review Catches Hidden Barriers

2026-05-23T00:00:00-04:00

Why should the dental team review a complex case before the case presentation to surface remaining barriers? Because team members often see patient signals the doctor missed and can identify barriers that would otherwise blindside the case presentation, leaving no time to address them. The pre-presentation review pulls together the relevant team members for a focused conversation about each upcoming case. The assistant who handled the diagnostic visit shares what they observed about the patient's reactions, anxiety levels, and statements during workup. The front office team member who interacted with the patient on the phone shares early signals. The financial coordinator [...]

Pre Presentation Team Review Catches Hidden Barriers2026-05-23T00:00:00-04:00

In Office CT Scenarios That Justify the Investment

2026-05-23T00:00:00-04:00

When does in-office cone beam CT actually make economic sense for a dental practice? In a small set of specific scenarios where the volume, isolation, or business model genuinely supports the equipment cost. The realistic scenarios include large oral surgery practices running enough implant and surgical volume that the scan utilization actually approaches the five-per-week claim. Practices in geographic vacuum locations where the nearest CT facility is hours away and patient travel becomes a barrier to imaging. Practices with substantial in-house marketing operations producing consistent big-case volume that justifies the imaging infrastructure. Doctors building a second business as a free-standing imaging [...]

In Office CT Scenarios That Justify the Investment2026-05-23T00:00:00-04:00

Cone Beam CT Economics for Dental Practices

2026-05-23T00:00:00-04:00

What does cone beam CT economics actually look like for a typical general dental practice? Substantially worse than the manufacturer's pitch suggests, especially for practices not running heavy implant or oral surgery volume. The manufacturer claim runs something like: do five full-mouth scans per week and produce $100,000 in additional imaging profit per year. The pitch glosses over operational realities. The lease payment on a unit runs $2,500 to $3,500 per month. Service and maintenance contracts add to the monthly cash burn. Staff training for any team turnover adds more. The scan volume claim of five per week assumes the practice [...]

Cone Beam CT Economics for Dental Practices2026-05-23T00:00:00-04:00

CAD CAM Surgical Guide Time Savings That Justify Cost

2026-05-23T00:00:00-04:00

When does a CAD-CAM implant surgical guide actually save enough time to justify its investment? When it enables flapless surgery and produces an hour or more in saved time per implant placement, which is the typical case for most implant procedures using these guides. The mechanics behind the saving are substantial. Traditional implant placement requires the surgeon to raise a flap, place the implant freehand or with a basic surgical guide, suture, and manage the soft tissue healing that follows. The full procedure consumes considerable chair time and recovery time. A CAD-CAM surgical guide, developed from preoperative cone-beam imaging and digital [...]

CAD CAM Surgical Guide Time Savings That Justify Cost2026-05-23T00:00:00-04:00

Tech Time Savings Threshold for Dental Equipment Decisions

2026-05-23T00:00:00-04:00

What time savings threshold makes a piece of dental technology genuinely worth its cost? Roughly twenty to thirty minutes saved per procedure, with anything below fifteen minutes rarely producing meaningful operational benefit. The math runs as follows. A device that saves five to ten minutes per procedure rarely translates into recoverable productive time because most doctors cannot reliably capture five-minute increments. The saved time leaks into transition, conversation, or simply lower throughput. Fifteen to twenty minute savings sit at the borderline. Some practices structured tightly enough to harvest those increments turn them into measurable additional production. Most do not. Twenty to [...]

Tech Time Savings Threshold for Dental Equipment Decisions2026-05-23T00:00:00-04:00

Dental Technology Sales Myth Quietly Drains Practices

2026-05-23T00:00:00-04:00

Why is the belief that dental technology sells dentistry actually a myth? Because most clinical technology in dental offices does not create revenue on its own, does not make patients magically appear, and rarely affects whether a patient says yes to treatment regardless of manufacturer marketing claims. The myth has deep roots in dental training. Students at teaching institutions watched patients accept treatment in environments equipped with the latest equipment and concluded that the equipment was producing the acceptance. The actual driver was the institution's reduced-fee structure, not the technology. The pattern repeats in private practice. Doctors buy the latest gadgets [...]

Dental Technology Sales Myth Quietly Drains Practices2026-05-23T00:00:00-04:00

Complex Case Profit Advantage Over Routine Dentistry

2026-05-23T00:00:00-04:00

Just how much more profitable are complex dental cases compared to routine general dentistry? Roughly 200 percent more profitable per case than the most profitable routine dentistry options, when the complex case work is set up correctly. The math compounds across several dimensions. Per-case fees in the $20,000 to $40,000 range or higher dwarf the per-procedure fees of routine restorative, hygiene, or single-tooth work. Per-hour production climbs from the $300 to $600 range typical of routine practices to the $1,000 to $1,500-plus range typical of complex case days. Overhead drops from 65 to 85 percent in volume practices down to 50 [...]

Complex Case Profit Advantage Over Routine Dentistry2026-05-23T00:00:00-04:00

Do Nothing Disclosure Obligation in Case Presentations

2026-05-23T00:00:00-04:00

Why is explaining the "do nothing" outcome part of a dentist's professional disclosure obligation? Because patients deciding about treatment need to understand the consequences of the option they have always had available, which is to continue doing nothing, and the doctor has a professional duty to make sure that consequence is honestly disclosed. The case presentation walks through three or four treatment options. The do-nothing option is the fourth or fifth: what happens to the patient's dental situation if they decline all of the recommended treatments and continue with their current trajectory. The disclosure is not a scare tactic. It is [...]

Do Nothing Disclosure Obligation in Case Presentations2026-05-23T00:00:00-04:00

Teeth Result Patient Language in Case Presentations

2026-05-23T00:00:00-04:00

Why should treatment option descriptions focus on "teeth" rather than on procedural details in patient-facing language? Because patients care about the end result rather than the steps required to produce it, and procedural details fail to communicate value while introducing terminology the patient cannot use. The patient sitting in the case presentation is there because they want their teeth fixed. They want comfortable chewing, the ability to eat what they want, a nice smile, and confidence in social situations. They are not there to evaluate the merits of immediate-load implants versus delayed-load protocols, or to understand the difference between zirconia and [...]

Teeth Result Patient Language in Case Presentations2026-05-23T00:00:00-04:00

Pause After Fee Statement Lets Patients Absorb

2026-05-23T00:00:00-04:00

Why is a deliberate pause after each fee statement so important during the dental case presentation? Because the patient needs time to absorb each fee individually, and rushing through the numbers prevents them from processing what they just heard. After stating a fee for one of the treatment options, the doctor pauses. The pause may feel uncomfortable in the moment, but it serves several purposes. It lets the patient internalize the number associated with that specific option. It gives them space to ask clarifying questions, which often surface during the pause as the patient connects the fee to the treatment description. [...]

Pause After Fee Statement Lets Patients Absorb2026-05-23T00:00:00-04:00
CONTACT
James McAnally,
DDS,FAGD,FICOI,FMII
Founder, Big Case Marketing
Cancellation – Refund Policy
See program authorization for contract details.
Terms and conditions apply.
No refunds.
PRIVACY POLICY
Go to Top