Student Guide
Practice before
the practice.
Read this before your first quarter. The simulation rewards informed decisions — and is unforgiving of uninformed ones, just like real practice ownership.
Pilot Program 2025
4–6 Weeks
8 Simulated Quarters
[Your School / Cohort Name]
Section 01
What is ClinicReady?
ClinicReady is a business strategy simulation built around real-world dental practice scenarios. You run a dental practice for two years — eight quarters. At the end, your practice is scored and appraised, and your result is benchmarked against your classmates and against historical cohorts.
The goal is not to maximise one number. It is to build a practice that is financially healthy, growing, well-staffed, and patient-facing — simultaneously. Every decision involves a trade-off, and those trade-offs compound over time.
💡
Think of it as a flight simulator for running your own dental practice. Make your mistakes here — not in front of patients.
Section 02
How You're Scored
Your composite score (0–100) is calculated each quarter from four pillars. Each pillar is scored independently, then weighted into your overall result.
35%
Financial Health
EBITDA margin, cash position, DSCR, PPO dependency. The dominant pillar.
25%
Growth & Value
Doctor production per hour, new patient acquisition, Google rating.
20%
Team & Operations
Staff morale, schedule utilization, and operational efficiency.
20%
Patient & Market
Google rating, utilization, PPO independence. Reflects your local market position.
Score Ranges
75–100
⬤ Outstanding
Outperforming peers on most dimensions. Strong DSCR, growing production, high morale.
60–74
⬤ Strong
Solid decisions across most pillars with visible room to improve one or two.
45–59
⬤ Developing
One or two pillars underperforming. Correctable.
30–44
⬤ Struggling
Multiple pillars weak. Difficult to recover in 2–3 quarters.
0–29
⬤ Critical
Severe mismanagement. Typically sustained staff neglect or catastrophic event handling.
📊
The DSCR (Debt Service Coverage Ratio = Annualised EBITDA ÷ Total Debt) is the metric most students underestimate. A DSCR ≥ 2.5x adds +22 pts to Financial Health. Below 0.5x costs you −20 pts.
Section 03
Simulation Tracks & Modes
Your faculty will assign your track, mode, and session type before the simulation opens. Make sure you know which applies to you.
Simulation Tracks
Track A
Inherited Practice
You start with an existing medium-sized general practice — staff, patients, and debt already in place. Core challenge: grow and optimise without breaking what works.
Track B
Build a New Practice
Clean slate: a location, $185K startup capital, and zero patients. Core challenge: survive the pre-launch and ramp phases before reaching operational stability.
Pedagogy Modes
| Mode | What changes | Bankruptcy risk? |
|---|
| Guided Discovery | Events fire at 60% severity. Mistakes are survivable and instructive. | No |
| High Stakes | Events fire at full severity. Financial mismanagement can result in practice bankruptcy. | Yes — Build a New Practice only |
Session Types
| Format | How it works |
|---|
| Solo | You run the practice independently. All decisions are yours. |
| Partner | Two students share one practice. A Partner Chat panel is available in-simulator. Decisions must be submitted jointly. |
| Small Group | Three to four students share one practice. Read-Assist mode is active: each student can view and comment on decisions before submission. |
Section 04
The Eight Quarters
Each quarter represents roughly one month of practice operations. Your decisions compound over time — early choices constrain or enable what comes later.
Q1 – Q2
Foundation
Set up your practice, hire your team, and see your first patients
Q3 – Q4
Growth
Navigate curveballs, manage cash flow, and adjust your strategy
Q5 – Q6
Pressure
Compete for patients, respond to market events, and control overhead
Q7 – Q8
Outcome
Finish strong and review your Final Report with CODA competency scores
Your faculty will run a mid-point check-in after Q4 to discuss decisions, share cohort trends, and help you course-correct before the final stretch.
Section 05
Your Decisions
Each quarter you submit decisions across four categories. You cannot change a decision after submission — review all options carefully before you click submit.
Revenue Decisions
| Decision | Range | Key trade-off |
|---|
| Fee Schedule Increase | 0%–15% | Elasticity kicks in above 2%/quarter — increases beyond this progressively suppress volume and damage your Google rating. Compound increases above 2% will crater utilization within 3 quarters. |
| High-Value Case Mix % | 10%–55% | Shifts toward implants, crowns, complex restorative. Reputation-gated: effective ceiling is ~27% at a 3.9 Google rating. Cannot push beyond your reputation ceiling. |
Growth Decisions
| Decision | Range | Key trade-off |
|---|
| Marketing Spend Δ | −$4,500–cap | Directly drives new patient acquisition. Over-investing before you have capacity is wasteful. |
| Recall System Investment | $0–$20,000 | Improves patient retention and reactivation. Compounding benefit — early investment pays off more than late. |
| Reputation Investment | $0–$15,000 | Builds Google rating. Critical for unlocking higher case mix ceilings. |
People Decisions
| Decision | Range | Key trade-off |
|---|
| Staff Raise % | 0%–10% | Boosts morale and permanently increases payroll base. Skipping raises accelerates morale decay each quarter. |
| Training Investment | $0–$10,000 | Offsets natural morale decay. Required for compliance event resistance. |
| Hire Hygienists (FTE) | 0–cap | Increases hygiene revenue ceiling. Permanently increases fixed costs — only hire when utilization justifies it. |
| Overtime Hours | 0–cap | Increases short-term production but drains morale at 0.65 pts/overtime hour. Escalation begins Q1 and multiplies 2.5× by Q3. There is no safe level of sustained overtime. |
Capital & Strategic Decisions (One-Time)
| Decision | Key trade-off | Best timing |
|---|
| Refinance Debt | Lowers interest rate permanently. | Q3–Q4 when DSCR and cash are strong |
| Buy CBCT Scanner | $85K upfront, +5% doctor production/hr. | Q4–Q6 after revenue base is established |
| Expansion Loan | +$200K cash, +$200K debt. | Only if DSCR > 1.5× |
| Hire Associate Dentist | Permanently increases doctor hours and fixed costs. | Only if utilization > 75% |
| Drop PPO Contract | 3-quarter transition with a utilization dip in Q1. | Q6–Q7 with strong cash — not when cash < $150K |
Section 06
Random Events
Each quarter, the simulation may fire a random event — a realistic challenge that dental practices actually face. You cannot predict which event will occur, but you can reduce their frequency and severity by running a well-managed practice.
⚠️
Base probability is 15% per quarter. Your hidden Fragility Index can push this to 50%. Fragility rises when: liquidity is low, utilization is above 90%, staff morale is low, or legal risk is elevated.
| Level | Frequency | Examples | Typical impact |
|---|
| LOW | 30% | Increase in No-Shows, Minor Supply Cost Increase | Minor cash costs ($2K–$8K) |
| MODERATE | 38% | PPO Fee Reduction, Lead Hygienist Resigns, Staff Burnout Warning | Meaningful cash impact ($10K–$35K) |
| HIGH | 24% | Malpractice Claim Filed, Operatory Chair Down, Cybersecurity Incident | Significant cash and score impact |
| CRITICAL | 8% | Mass Staff Walkout, Major HIPAA Violation, Malpractice Premium Shock | Severe multi-pillar impact. Low-morale practices are most vulnerable. |
Section 07
Common Mistakes
These are the most frequently observed mistakes across all cohorts. Read them before Q1.
💸
Aggressive fee increases every quarter
Fee elasticity kicks in above 2% per quarter. A team that increases fees by 5% every quarter will see utilization and Google rating decline noticeably within 3 quarters. Keep increases at 2% or below and let them compound.
⭐
Pushing case mix beyond your reputation ceiling
At a 3.9 Google rating (starting value), the effective ceiling is ~27%. Trying to push beyond it actively damages your reputation — and lowers the very rating that determines the ceiling. Build reputation first.
⏰
Treating overtime as a safe short-term lever
The drain rate is 0.65 morale points per overtime hour. Escalation begins in Q1 (not Q2) and reaches 2.5× by Q3. Even 20 hours/quarter produces meaningful morale decline within two quarters. Use only as a single-quarter emergency — never sustained.
😟
Ignoring morale until it's too late
Morale decays 0.8–2.0 points per quarter without investment — faster if you skip both raises AND training consecutively. At zero morale, Fragility Index spikes, event probability approaches 50%, and Team Ops score bottoms out.
👨⚕️
Hiring an associate before capacity supports it
An associate permanently increases both doctor hours and fixed costs. If utilization is below 75% and marketing spend is low, you're adding payroll you cannot fill.
📋
Dropping PPO in a cash-thin quarter
PPO exit plays out over three quarters with a utilization dip in Q1 of the transition. If you initiate when cash is below $150K, you may not survive the transition period.
📢
Treating marketing as the only ramp lever (Build a New Practice)
Marketing buys ~33% less ramp progress per dollar than students expect. Early reputation investment multiplies every marketing dollar. Pair moderate marketing with consistent reputation investment — don't just max out marketing spend.
Section 08
Strategic Tips
Early Game — Q1 & Q2
Start with a 2% fee increase — below the elasticity threshold. Every quarter you delay costs compounding revenue, but every percent above 2% triggers diminishing returns.
Invest in recall and reputation early. Reputation investment unlocks higher case mix ceilings later.
Issue a staff raise in Q1 or Q2. Morale above 60 gives meaningful headroom before decay becomes a problem.
Spend on training to offset natural morale decay and build compliance resistance.
Do not rush capital decisions. CBCT, associate hire, and expansion loan all have better ROI mid-to-late game.
Avoid overtime entirely in Q1 and Q2. The escalation mechanics mean early overtime creates compounding damage.
Mid Game — Q3 to Q5
Consider refinancing in Q3–Q4 once your financials are visibly stronger.
Add a hygienist when utilization is consistently above 75%.
Begin shifting case mix once your Google rating has risen above 4.1 — the ceiling lifts meaningfully above that threshold.
If you're going to drop PPO, plan to initiate in Q6–Q7.
Late Game — Q6 to Q8
Accelerate extra debt paydown in Q7–Q8. Lowering debt improves DSCR, financial health score, and equity value simultaneously.
Keep marketing spend elevated. New patient flow in Q7–Q8 directly affects your Patient & Market pillar score.
Do not take new debt in Q7 or Q8 unless the use case is immediate and high-return.
Section 09
Using the Simulator
The simulator runs in your browser — no installation required. Your progress is saved automatically to your team link.
📊 Dashboard
Current KPIs, pillar scores, quarterly summary, coaching notes, and the leaderboard. Start here every quarter.
🏗 Founding
Build a New Practice only. Founding decision panel during Pre-Launch and Ramp phases. Ramp Progress card visible here.
⚙️ Decisions
The decision input panel for the current quarter. Review all options before submitting — you cannot change a submitted quarter.
📈 Performance
Pillar trajectory charts, strategy indices, and attribution analysis.
💵 Cash Flow
Waterfall chart breaking down revenue, costs, debt service, and net cash.
👥 Team
Morale trend, staffing levels, utilization, and fragility index over time.
💬 Partner Chat
Partner and Small Group sessions only. In-simulator messaging panel.
🔁 Replay / What-If
Replay your full run or branch from any quarter with alternative choices to compare outcomes. Use after your run to understand the cost of early decisions.
📋 Final Report
Available after Q8. Full analysis, decision impact summary, valuation breakdown, CODA competency table, and cohort comparison.
🏆
The Leaderboard shows your cohort rank updated live as quarters are submitted. A gold banner displays your final rank once all data has loaded. Check it after each quarter to see how your strategy is placing you relative to classmates.
Section 10
Quick Reference Card
Keep these thresholds in mind every quarter.
Key Thresholds
Fee Increase ElasticityKicks in above 2%/quarter. Stay at or below this threshold every quarter.
Case Mix Ceiling~27% at a 3.9 Google rating. Build reputation before pushing case mix higher.
Overtime Morale Drain0.65 pts/hour. Escalation from Q1. Multiplier reaches 2.5× by Q3.
NP Ramp CapCannot reach Operational phase before Q6 regardless of spend. Plan cash accordingly.
Watch These Numbers Every Quarter
| Metric | Warning Zone | Action |
|---|
| Staff Morale | Below 45 | Issue a raise or training investment immediately |
| DSCR | Below 1.0× | Reduce debt or grow EBITDA — both if possible |
| Schedule Utilization | Below 60% | Increase marketing and recall investment |
| Cash | Below $80K | Pause capital decisions; prioritise collections |
| Fragility Index | Above 40 | Back off overtime; invest in morale and liquidity |
| Case Mix % | Near Google-rating ceiling | Invest in reputation before pushing higher |
| Fee Increase Rate | Above 2%/quarter | Reduce — elasticity penalties already active |
| Ramp Progress (NP) | Cash runway < 8 weeks | Emergency cost reduction or capital decision required |
Section 11
Getting Started
Two things must be complete before your first login. Both are required.
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Complete the Pre-Simulation Survey — Your faculty will send the link. Takes 5–8 minutes. Must be done before Q1 opens. Responses won't affect your grade — they're used for educational research.
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Attend the Pre-Simulation Briefing — 30–45 minute class session where your faculty walks through the platform and an example quarter.
Accessing Your Simulation
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Get your unique team link from your facultyDistributed via LMS, email, or class channel. Your link is specific to your team — keep it, don't share it publicly.
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Open in Chrome or Safari and bookmark itProgress is saved automatically to your link. Return to the same URL each session.
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Confirm the setup screen loadsIf anything looks wrong, contact your faculty — don't try to regenerate the link yourself.
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Wait for Q1 to openYour faculty controls when each quarter opens. Until then, explore the dashboard and review your starting conditions.
Your Simulation Link
Provided by your faculty
Bookmark this. Your progress is tied to this URL.
Your Semester at a Glance
Week −1
Pre-Simulation SurveyComplete before Q1 opens. Link sent by your faculty.
Week 1
Briefing & Q1 Opens30–45 min class session. Faculty walks through an example quarter before play begins.
Wks 1–4
Simulation Play (Q1–Q8)All eight quarters. Mid-point debrief after Q4.
Wks 4–5
Final Debrief45–60 min session reviewing your Final Report, CODA scores, and cohort benchmarks.
Wks 5–6
Post-Simulation Survey5–8 minutes. Required before the program closes.
✉️
Questions? Email [email protected] or speak with your faculty. The ClinicReady team responds within 24 hours on weekdays. Good luck — the decisions are yours.