LeanBlog Podcast #29 — Interview with Dr. Sami Bahri, The World’s First Lean Dentist, on How It’s Transformed His Practice



LeanBlog Podcast #29 features a very special guest, Dr. Sami Bahri, “The World's First Lean Dentist.”

If you're thinking, “What can I learn about lean from a Dentist?”, please listen in. I think you'll be amazed and will learn a ton. I've really enjoyed the two chances I've had to talk with Dr Bahri, including this podcast session and I've been very impressed with his approach to lean.

He's gone back to all of the source texts, including Shingo and Ohno and has really had to figure it out for himself, as opposed to following some sort of cookbook approach. I particularly appreciate how he involves his employees and staff… it's a great example we can all learn from.

If you have questions or comments for Dr. Bahri, he's agreed to a follow on podcast. You can email me at leanpodcast@gmail.com or visit leanpodcast.org to leave a comment or read some linked articles about Dr. Bahri.

If you enjoy this podcast, I hope you'll check out the rest of the series by visiting the LeanBlog podcast main page.

Keywords and Main Points, Episode #29

  • Learning about Lean and figuring out, over time, how to apply it to a dental office.
  • How Dr. Bahri is able to take care of patient needs all in a single visit (not coming back for separate follow on appointments).
  • How Dr. Bahri has engaged his workforce, through Lean, to improve productivity, job satisfaction, and employee engagement.
  • Lean as a never-ending journey toward perfection, an experimental process.
  • Learn how Dr. Bahri's office creating an innovative “flow manager” position.

If you have feedback on the podcast, or any questions for me or my guests, you can email me at leanpodcast@gmail.com or you can call and leave a voicemail by calling the “Lean Line” at (817) 993-0630 or contact me via Skype id “mgraban”. Please give your location and your first name. Any comments (email or voicemail) might be used in follow ups to the podcast. Click here for the main LeanBlog Podcast page with all previous episodes.

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Mark Graban
Mark Graban is an internationally-recognized consultant, author, and professional speaker, and podcaster with experience in healthcare, manufacturing, and startups. Mark's new book is The Mistakes That Make Us: Cultivating a Culture of Learning and Innovation. He is also the author of Measures of Success: React Less, Lead Better, Improve More, the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, and the anthology Practicing Lean. Mark is also a Senior Advisor to the technology company KaiNexus.


  1. My wife has a medical practice and has become intrigued by Lean as I’ve begun to blog on related topics.


    As the management of the practice is rarely a consideration in the education of medical professionals (I think she had one class on practice management), this is likely fertile ground for process improvement.


  2. Q&A with Dr. Bahri:

    Q: From a patient perspective, if I have a cleaning, I know to carve out an hour from my day. Do your patients ever say, “No, I’ll have to come back a different day” because of work schedules, etc. if you find a cavity, etc. during an exam? I know your goal is to do it all in a single visit, if possible, but that’s mostly driven by patients who prefer to not come back, I assume?

    A: The strength of Lean is that it makes it possible to offer same-vsit treatment to our patients. We do not try to force it upon them obviously.

    Yes, some patients prefer to come back; we accommodate that too.

    We also have cases where it is not indicated to do a lot of work at once:

    1. Age: young or elderly.

    2. Health conditions

    3. Financial limitations

    4. Just preferring a slower pace, etc.

    But the majority of our patients, over 90%, prefer the same-visit treatment.

  3. Another Q&A with Dr. Bahri (thanks to Lawrence, from Canada) for the question:

    Q: Let me first say thank you for your interview with Dr. Bahri. It was most interesting and informative. My question has to do with managing production time of the dentists. Dr Bahri has stated that his core unit is the hygiene appointment. If you do not know what restorative needs your continuing care hygiene patient is bringing to your office, and her or his expectations are that your will resolve what ever needs that they have at that appointment how do your organize effectively the doctor’s production so that he is always productive and on time?

    A: Dear Lawrence,

    We focused on hygiene because we decided to shift our attention to making to patient’s time as the basis for our scheduling, instead of the doctor’s. Hygiene and general dentistry appointments became synchronized in the same chairs. If the hygiene department were still separate, we would have to analyze the hygiene process separately from the dental processes.

    The dentist stays productive by treating one mouth at a time. For instance, I have worked all day today on one patient, in one chair, with one assistant. The patient took a few breaks where I did some hygiene exams, and simple procedures. The patient’s whole mouth is treated and he will come back for cleanings and checkups only.

    So how can we stay productive and organized if we can’t anticipate the patient’s need after the hygiene exam?

    Since we work in long appointments, several things could happen during the visit. The most frequent is finishing early. We need to give the patient breaks to rest, and some parts of the treatment can be delegated to the assistant. If the patient needs a cleaning, the hygienist will come to the room and clean their teeth. We also have cancellations, unfortunately, or patients deciding to have less work than previously planned. You would probably find more instances where unpredictable variation strikes. All the above allow the dentist to have some time away from the chair without interrupting the patient treatment.

    To take advantage of that time we utilize three factors:

    1. Short setup times based on the SMED principles of internal and external setups.
    2. A Flow manager, rearranging the schedule constantly to meet the changes in demand
    3. A Kanban pull system where the flow manager directs everyone, dentist included to the most useful processes.

    It might sound complicated, but in practice it is much slower in pace than batch management and the dentist is much more productive.


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