Practice profitability is directly tied to the establishment of accounting systems relating to the control of practice expenditures. Looking back at expenditures from prior years is essential in determining the areas in your practice that need improvement. Dental consultants and CPAs can be of assistance in this process. The second step – and most important – is following the budget. Your bookkeeper must be trained to spot the areas that exceed your budget guidelines and make adjustments. Staff must have all supply orders authorized prior to placing them. Major facility and equipment decisions should be reviewed with a CPA prior to purchase to determine the profitability of the expenditure.