Nothing clinical. No exceptions, and I have turned down work over it.
Two Zahnarztpraxen, both owner-operated: one with three chairs, one solo with two staff. Neither wanted AI. One wanted to stop losing €4,000 a month to no-shows. The other wanted to stop writing notes at 20:00.
For the first practice it is the recall list: patients due for a check-up who quietly never return, because reminding them is somebody’s afternoon and nobody has the afternoon. For the second it is documentation — notes dictated between patients, written up after closing, plus the Heil- und Kostenplan explanations that patients do not understand and therefore do not accept.
- The recall list: who is due, contacted how, with what response
- Appointment reminders and the confirmation loop
- Filling cancellations from a short-notice waiting list
- Turning dictation into structured chart notes in the practice’s own format
- The plain-language explanation of an already approved treatment plan and its costs
- Insurance and billing paperwork: BEMA/GOZ assembly, Kassenanträge, chasing
- Rota, sterilisation logs, stock levels, and the documentation the Praxisbegehung will ask for
- Diagnosis. Every part of it
- The treatment plan
- What to tell a frightened patient
- Whether to treat at all
- The recall engine
- Due patients identified and reminded on a schedule, escalating from message to letter to a call list for the front desk. In the first practice, no-shows fell by a bit over half and the recall gap closed within four months. Pure arithmetic, no clinical content whatsoever, and it paid for everything else.
- The cancellation filler
- A slot opens at 09:40; the short-notice list is offered it automatically in order. Empty chairs are the largest recoverable loss in a practice and the process is entirely mechanical.
- The dictation-to-note pass
- The dentist speaks; the note appears in the practice’s structure. They read and confirm every single one before it enters the record. Nothing enters a patient record unconfirmed, ever.
- The patient explanation sheet
- From an already approved plan, a plain-language version: what will happen, in what order, what the Kasse covers, what the patient pays, and what the alternatives are as specified by the dentist. Acceptance improved noticeably, for the unremarkable reason that people say no to things they do not understand.
- The compliance folder
- Sterilisation logs, maintenance dates and training records assembled continuously instead of panicked before an inspection.
No diagnosis, no image reading, no triage — and no note enters a record unconfirmed.
No suggestion of a diagnosis, no reading of an X-ray or an OPG. No treatment recommendation, no ranking of options, no prognosis. No triage of symptoms, not even a phone script that sorts urgency, because a wrongly sorted abscess is a real harm. No patient message about a clinical matter is sent without the dentist reading it.
And the data rules, which are strict: patient data is Article 9 special-category data. Everything clinical stays inside the practice system, pseudonymised at any boundary it must cross, DSGVO-compliant processing with an AV-Vertrag, EU residency, no training on patient content, retention per the Aufbewahrungspflicht, and full access logging. Where a workflow cannot meet those conditions, it does not get built.
No-show rate. Recall gap — patients overdue and uncontacted. Empty chair hours per week. Minutes of documentation after closing. Treatment plan acceptance rate.
Anything approaching clinical decision support, symptom triage or image reading. Both practices asked about image reading and both accepted the answer. The regulatory route for that exists — it runs through medical device certification — and it does not run through me.
Confirming every note. Which is the legal requirement anyway.
I did not want AI, I wanted to stop losing four thousand euros a month to empty chairs. He spent two days sitting at our front desk, which is not where I expected to be told to look. Recall and short-notice filling were installed first, nothing clinical at all, and no-shows fell by more than half within a quarter. That paid for everything afterwards and it earned the trust for it.
Notes are dictated between patients and written up in our own structure, and I confirm every single one before it enters the record — which is the legal requirement anyway. I asked about reading OPGs and he said no and explained that the route for that runs through medical device certification and not through him. I have had three vendors tell me the opposite, so his answer is the reason I believed the rest of what he said.
Tell me what your week looks like.
I'll tell you honestly which parts you can hand over — and which you can't.