Practice Performance Review
Peak Family Dental — Flagstaff, Arizona
Your advertising is working, and your team closes beautifully. The problem is in the middle: too few leads ever make it into a consult chair. This year you spent $22,500 across five active months and it produced 288 new leads and 6 accepted implant cases worth $73,627 — about a 3.3x return on ad spend, and your best cases are still in progress. The reason it isn't more: only about 4 out of every 100 leads book an appointment. Once they do, 80% show up and 89% say yes to treatment — that part is excellent. You paused spend in March, and again from July, when it looked like it was running in the red. The numbers below add helpful context: on accepted treatment it is running about 3.3x, and cases take months to close — so recent spend has not finished paying out. Fix the hand-off from lead to booked visit and this program roughly doubles on the same budget.
The numbers that matter
What's working, and what isn't
- Your team closes. When a lead actually shows up, 89% accept treatment. That is elite case acceptance — the doctor and coordinators are excellent chairside.
- People show up. 80% of booked consults keep the appointment. Your reminders and confirmations are doing their job.
- Leads are plentiful and cheap. 288 leads at $78 each. The ads are reaching the right implant-minded patients at a good price.
- The cases are large. This year's accepted cases run up to $50,000; lifetime average is roughly $18,000. The model produces real full-arch revenue.
- Cases keep maturing. More than half of sales close within a month of the lead, but a real tail keeps paying out for months — so your recent leads are still in play.
- Leads aren't yet turning into visits. About 4 in 100 leads book a consult, versus 8-15 at a well-run implant practice. This is the whole opportunity — the spend is buying real interest that isn't yet making it onto the schedule.
- The biggest lever is live phone follow-up. Leads currently move through automated text sequences; pairing those with a fast personal phone call is the proven way to lift booking on implant leads.
- Booking volume, not closing, is the constraint. 2025 averaged 1.7 cases a month and 2026 is closer to 1 — a reflection of fewer booked consults, not the close rate, which stays excellent.
- The numbers read low because wins aren't fully captured. When accepted cases aren't logged as won, the CRM understates what the program is actually producing — capturing them makes the true return easy to show.
- The pause is worth a second look. Pausing when the numbers looked thin was reasonable. Because implant cases take months to close, some of this year's spend is still paying out — so it's worth checking collections before deciding whether to keep it paused.
Where leads drop off before booking
Think of it as a funnel. Out of every 100 leads the ads bring in, here is roughly how many make it to each step:
The same funnel, in real lifetime numbers
What this means for you
You are not losing cases at the consult — you are losing them before the consult ever happens. Every extra lead we convert into a booked visit is worth roughly $12,000 in accepted treatment at your current close rate. Moving from 4% to 8% booked would roughly double your cases without spending another dollar on ads.
The most likely cause: speed to lead
Implant leads go cold fast — the practices that win call a new lead within 5 minutes, by phone. Today leads flow through an automated text sequence, and layering a fast personal call on top is the highest-leverage change available. One note on measuring it: the account is set to HIPAA-compliant mode, which locks message and call history from any report, so we could not calculate current response time directly (we confirmed this). To start tracking it, add call tracking (or export GoHighLevel's own in-app response-time report, which is available to a logged-in team member). This is the single number most worth watching.
Your cases this year
| Case accepted | Lead came in | Case value | CRM status |
|---|---|---|---|
| 2026-01-23 | 2025-12-29 | $10,000 | open |
| 2026-03-24 | 2026-02-18 | $0 | won |
| 2026-05-12 | 2026-04-13 | $5,000 | won |
| 2026-06-01 | 2026-01-29 | $1,027 | open |
| 2026-06-29 | 2026-06-18 | $50,000 | open |
| 2026-06-30 | 2026-06-19 | $7,600 | open |
| 6 cases | $73,627 |
How these six are counted
These are the cases where a patient accepted treatment during 2026, dated to the month they said yes. Cases accepted in earlier years are counted in those years and remain active in the pipeline, so this list intentionally isolates this year's production — the piece that lines up with this year's ad spend.
Leads in vs. cases out, month by month
| Month | New leads | Cases accepted | Case value |
|---|---|---|---|
| Jan 2026 | 57 | 1 | $10,000 |
| Feb 2026 | 37 | 0 | — |
| Mar 2026 | 2 | 1 | $0 |
| Apr 2026 | 68 | 0 | — |
| May 2026 | 61 | 1 | $5,000 |
| Jun 2026 | 63 | 3 | $58,627 |
| Jul 2026 | 0 | 0 | — |
| Year to date | 288 | 6 | $73,627 |
New leads (blue) vs. cases accepted (green)
Leads are counted when they inquire; cases are counted when the patient accepts treatment — so a June case may trace to a January lead. Ad spend was paused in March and again from July, which is why those months show little or no new-lead activity.
The bottom line — a monthly P&L
Closed revenue by the month the case was accepted, at an assumed 40% gross margin (after labor, lab fees, and referral kickbacks), with marketing layered on to reach net income. Spend ran five months — March and July were paused, so no ad cost those months. Year to date the program is slightly ahead of break-even, about +$6,951, with one strong month (June) carrying it, which is normal for high-ticket implant work.
| Month | Revenue | Direct costs | Gross profit | Marketing | Net income |
|---|---|---|---|---|---|
| Jan 2026 | $10,000 | -$6,000 | $4,000 | -$4,500 | -$500 |
| Feb 2026 | — | — | — | -$4,500 | -$4,500 |
| Mar 2026 | — | — | — | — | — |
| Apr 2026 | — | — | — | -$4,500 | -$4,500 |
| May 2026 | $5,000 | -$3,000 | $2,000 | -$4,500 | -$2,500 |
| Jun 2026 | $58,627 | -$35,176 | $23,451 | -$4,500 | $18,951 |
| Jul 2026 | — | — | — | — | — |
| YTD 2026 | $73,627 | -$44,176 | $29,451 | -$22,500 | $6,951 |
Net income by month
How to read this — a conservative view
Three things make this figure the floor, not the ceiling: (1) revenue here is accepted treatment logged in the CRM, not yet-collected cash — reconcile against your practice software to confirm what paid. (2) Your April–June leads have not finished closing (see the lag below), so more revenue from this year's spend is still coming and isn't in these numbers. (3) The 40% margin is a planning assumption; your real full-arch margin may be higher. The takeaway: the program pays for itself today and improves as recent leads mature — the upside is entirely in fixing the lead-to-booking gap.
When marketing pays off — the lag
Implant cases don't close the day the lead comes in. This grid shows the month a lead came in (rows) against the month the case closed (columns). The blue-outlined boxes are same-month closes; everything to the right is the wait.
| Lead came in ↓ Case closed → | Nov '24 | Dec '24 | Jan '25 | Mar '25 | Apr '25 | May '25 | Jun '25 | Jul '25 | Sep '25 | Oct '25 | Nov '25 | Dec '25 | Jan '26 | Mar '26 | May '26 | Jun '26 | Cohort total |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Oct '24 | 1$50k | 1$50k | 2$100k | ||||||||||||||
| Nov '24 | 4$28k | 1$8k | 1$17k | 6$53k | |||||||||||||
| Dec '24 | 1$10k | 2$20k | 3$30k | ||||||||||||||
| Jan '25 | 1$0 | 1$0 | |||||||||||||||
| Feb '25 | 1$25k | 2$75k | 1$31k | 4$131k | |||||||||||||
| Mar '25 | 2$35k | 2$27k | 4$62k | ||||||||||||||
| Jun '25 | 1$5k | 1$5k | |||||||||||||||
| Jul '25 | 1$11k | 1$11k | |||||||||||||||
| Aug '25 | 1$272 | 1$13k | 2$13k | ||||||||||||||
| Sep '25 | 1$15k | 1$15k | |||||||||||||||
| Oct '25 | 1$18k | 1$18k | |||||||||||||||
| Dec '25 | 1$10k | 1$10k | |||||||||||||||
| Jan '26 | 1$1k | 1$1k | |||||||||||||||
| Feb '26 | 1$0 | 1$0 | |||||||||||||||
| Apr '26 | 1$5k | 1$5k | |||||||||||||||
| Jun '26 | 2$58k | 2$58k | |||||||||||||||
| Closed total | 1$50k | 5$38k | 4$70k | 1$25k | 2$75k | 1$31k | 2$35k | 4$40k | 1$11k | 2$15k | 1$18k | 2$30k | 1$10k | 1$0 | 1$5k | 3$59k | 32$513k |
How quickly cases close after a lead
Why this matters to you
Only 13% of cases close in the same month the lead arrives. About 56% close within one month, 81% within three, and some take up to a year. This is the key context for the July pause: your newest leads (April–June) are still converting, so this year's spend has not finished paying out. Judging the program on cases closed so far understates it, and staying paused stalls cases already in the pipeline. Reconcile against collections before deciding whether the pause should continue.
What we recommend
| Action | Who | Impact | Effort | |
|---|---|---|---|---|
| 1 | Call every implant lead within 5 minutes — by phone, not just text. This is the single highest-value fix. The leak is entirely at lead-to-appointment; a fast human call is how you close it. | Front desk + Grow Dental | High | Low |
| 2 | Revisit the pause using collected dollars. Accepted-treatment return is running ~3.3x. Confirming it against what has actually been collected will show whether the program is worth un-pausing — and because cases are still maturing, some of this year's spend is likely still paying out. | SGA + Peak | High | Med |
| 3 | Log each accepted case with its dollar value in the CRM. It makes the program's return easy to prove and track over time. | Peak coordinators | Med | Low |
| 4 | Reconcile these cases against your practice software. Confirm which accepted cases actually scheduled and paid, so we can report true collected revenue, not just accepted treatment. | SGA + Peak | Med | Med |
| 5 | Work the backlog. Hundreds of past leads never got a real phone call. Given your 89% close rate, calling the strongest ones is the cheapest new revenue available. | Peak coordinators | Med | Med |