Archive for February, 2011

Increasing New Patients

Monday, February 21st, 2011

I received some great news this morning from one of our 2005 clients in Michigan. Not only has it been cold there but the recession really hit them hard.

 

She shared with me..

 

Last January was slowwwww–recession, etc. So, I printed 5,000 flyers and went to schools, physicians offices, pharmacies and local businesses and organizations with my flyers! (Trust me…it wasn’t her staff that went, it was Kathy the dentist and her team!) We offered free exams and x-rays for uninsured patients for February Children’s Dental Health Month and my practice has been booming ever since. Comparing January 2010 to January 2011, my production is up 61.7%! We offered the same again this month with great success. We’ve already seen 68 new patients this year.

 

It has been nice these past 5 years to have your systems in place. We always have a consistent plan of action and my employees know exactly what their respective jobs/responsibilities are. I have just as much energy at the end of the day as when I started the day. LOVE THAT!

 

Dr. Kathy is happy, positive and SHE and HER TEAM….MADE IT HAPPEN! Congratulations!

 

Be proactive this week…..you too can MAKE IT HAPPEN!
Sally

Bonus Plans

Sunday, February 20th, 2011

Hello Sally,

I, along with many others, have heard you speak and followed your online newsletters for years. I don’t know why, but I have always felt as if you were more practical, on target, down to earth and honest than most of the other “high powered” consultants I have observed. It is because of my intuition I am asking you for guidance on this most delicate and yes, always reoccurring topic.

 

I have recently hired two new employees who will be starting in two weeks. With new people coming in, I would like to seriously entertain the idea of a bonus system. Besides the obvious of knowing your BAM and going from there, what types of percentages do you allocate to the bonus system? Who is eligible, only full time people? Do you pay it on the efforts as a group only? What happens if you have a significantly less motivated individual who doesn’t contribute as much as the others? Is there a way of calculating and rewarding for individual efforts in addition to the group bonus? I would like to calculate it quarterly since I am the only dentist and I would not want the staff to feel that if the doc isn’t here for a few days there is no way they will make bonus so, let’s not even try this month.

 

My goal is to present this in the best way possible so I don’t make an error. It is so hard to retract anything once you say it.

 

Thank you for taking the time to read this and respond.

 

Sincerely,
Dr. Pamela

 

Hi Dr. Pamela,
Thank you for taking the time to write and for the kind compliment. I come from very humble beginnings and I believe that one should never forget that, no matter where you go in life.

 

Bonus systems, plans, etc. came out in the 80’s via the corporate culture and took a few years to get to dentistry. Human resource managers told Corporate America that if they dangled a financial carrot in front of their employees, they can expect a tremendous increase in their performance.

 

Going in to dental practices as a consultant throughout the U. S., I began to observe many, many flaws in its being successful for a small business like dentistry.

 

The biggest flaw is that they are always a “win-win” for employees. That is, the employees always get their base salary even if revenues go down. If revenues go up, they get their base + bonus. For the employer, it is a “win-lose”. If the revenues go up, the dentists gets more. However, if the revenues go down, the dentist still has the liability of paying the base salaries to the employees. This is just not a fair situation. It is making the employees business partners, but they are not willing to take the downside, i.e., reduced paychecks should the revenues go down.

 

Bonus plans are unfair because they usually reward employees equally, but the contributions to the business are not equal. Your dental practice can increase because a new employer moved to town, you took a treatment presentation course, you had a management consultant in the practice, you contracted with an internet marketing company, one employee brought in two families as new patients, etc.

 

Bonus plans cause employees to focus on money. It takes away from the performance indicators of a particular job. For example, at team meetings they talked about working a little harder and the rewards of the bonus would be there even though they really didn’t understand the “formula” of how the bonus was calculated. In the meantime, their patient retention dropped from 95% to 82%. This told employees that a downturn in job performance is satisfactory as long as more money is being made.

 

Believe me, dentists become resentful writing out bonus checks when they know that they sold more dentistry, but they continue to keep bonus systems because they are now afraid of a mutiny.

 

If you pay bonus, it has to be paid on “profits”. Then, you are going to have to explain to your employees how you calculated it and run the risk of becoming trapped by the “IRS auditor” syndrome. To be honest, the staff does not even want to know that information. All they want to know is, “Are we going to get our bonus this month because I’ve already spent it.” And you said it below…..try taking the bonus away from them.

 

Listen, employees expect to be paid a fair wage for the job they do. And yes, I certainly believe that employees should be rewarded for performance that exceeds their job description. If Susie brought in two families this month, she should be rewarded. What’s the reward? Whatever you want. $100, gift certificate for a massage, next Friday off with pay, dinner for two. Take them to a dental convention and CE course, for example. But, please think twice about giving them stock in your business.

 

Having said all of the above and you are still set on a bonus plan, allow me to give you some suggestions. The industry average for employee wages is 19% to 22% of monthly collections. Payroll taxes and benefits are an additional 3% to 5% for a total of 22% to 27% of collections. If yours is higher than 27%, you should NOT even consider it until these costs are in range. Let’s say that your employee costs average $8,850/month and you desire to pay no more than 20% of your collections for gross salaries. $8,850/month is 20% of $44,250 in collections. Let’s say next month your collections are $47,250. 20% of $47,250 is $9,450. This is $600 difference in what you are paying now for employees. Instead of dividing the $600 evenly among employees, consider dividing 75% of the $600 and put 25% in a “pool” that can be used for employee costs on those months when collections go below goal. If there are any monies left at the end of the year in the pool, then throw a party for them! Employees should know from their hire date that the goal is reevaluated every month and can be raised, lowered or abolished at any time.

 

However, my final word is… reward for performance that exceeds the job description and no bonus plans.
For further information on this subject, consider getting my book, How To Reward Your Dental Team.

 

Let me know if you have any other questions,
Sally

Who to hire?

Tuesday, February 15th, 2011

Hi Sally,
I’m trying to decide who I should hire for my front desk manager. I just purchased two of your on-line employee tests and I tested both of the ladies I thought would be great for the position and now I don’t know what to do.

 

The test showed a better match for Susan who doesn’t have such great references, a history of changing jobs and less experience. But, I had her go on a lunch date with my staff and they loved her. The other applicant, Janet, had glowing references from 3 dentists. I loved her on a working interview and she has a history of staying on the job. The last doctor she worked for said that he didn’t want her to leave and that she was the greatest employee he had! I am so confused! I just want to hire the right one and not have a bad situation. Any insights?

 

Thanks you,
Karen

 

Dear Karen,
Thanks for your email. Well….my first reaction is that “my” test on my web-site, www.mckenziemgmt.com
which I am assuming you are referring to, illustrates the best applicant based on personality
type and ability compared to other peak performers in the industry. However…..it doesn’t test on
job longevity. It’s rare to get a dentist to give a reference. However……if the dentist is a male
and the applicant a female…I suppose there is always a possibility that the two had more than
a working relationship! But the fact that Janet had glowing references and your “gut” told you
on the working interview that it was a “yes” and she has a history of job longevity (high points with me), I would probably pick Janet.
Good luck,
Sally

Office Manager Dilemma

Friday, February 11th, 2011

Dear Sally
It seems that we are working around our staff instead of for our patients. I get very depressed because the owner does not let me do my job. He tells me one thing then will turn around and say the opposite to someone else. I have been in the dental field since 1976. Are there any pointers I can give him at our next meeting? Would love to hear from you and get your input.

 

Thanks,
Cindy
Office Manager

 

Dear Cindy,
First of all, remember what your Mother always told you? If you can’t stand the heat…get out of the kitchen. The fact that your job and or environment is causing you to be “depressed” and leaves you feeling bad….well, who wants to deal with that day in and day out? Not me. Now, it depends on personality types. Mine for example, has no problem being confrontational. I would request a meeting with my employer and I would tell him how his behavior is affecting not only your performance but the attitude of all the employees. You, nor the employees, know who to trust at this point. You’re supposed to be a “boss” as an office manager but then the real “boss” undermines you. That means he has no respect for you and does whatever he wants in order that whomever he is dealing with, at the time, “likes” him. You do not want to call him out at the meeting, if staff are there, but this must be done privately. My guess is that he won’t change. My guess is that his behavior as you see it now has been that way for years and years and years.
I’d reference back to my 2nd sentence.

 

Hope this helps.
Sally

Dental Assistants – How Many?

Wednesday, February 9th, 2011

Hi Sally,
I have been a long time reader of your newsletter. I was wondering if you had an idea of how many assistants you would need. I am a general dentist for the last 31 years. I see anywhere from 12 to 24 general dental patients a day. I currently have three assistants and work out of 3 rooms. I wanted to know if you had a way to measure how many assistants are needed based on patients per day. Thanks in advance for your help with this.

John S., DDS, FAGD

 

Hi Dr. S,
Thank you so much for reading my newsletter. I think it’s been 8 years now!

I’m not sure that you know that I started as a dental assistant when I was 16 working in the office where my mother worked as a dental assistant. I later became Certified and also took the first expanded duties test in the state of Ohio to place restorative material in 1976 and taught dental assisting for 5 years from 1975 to 1980 when I started my consulting business.
So, I am coming from a position of knowing this area…..that was a long winded point, huh?

 

One assistant can assist with up to 13 doctor patients per day. It is an old wive’s tale that one assistant is needed for every treatment room you work out of. Suffice it to say, I would say that you are “probably” overloaded by 1 assistant. I say “probably” because I can’t see how you schedule, don’t know what state you are in to determine what the law is for delegation of duties to an assistant or that you agree with that. Expanded function scheduling where assistants would be allowed to place restorative material might be the only reason where 3 would be needed. Because, one is placing fillings while another might be making a temporary crown and the other one is with you. So, without looking at your schedule… I can’t tell for sure. But, I would be looking for times when a second or 3rd assistant is struggling trying to find something to do. I mean, let’s face it, there’s only so many cotton rolls you can stock in a drawer, right?

 

The 12 to 24 general patients should not include your hygiene exams on hygiene patients. Just your scheduled patients. Even so, I’m still guessing one too many assistants.

 

Hope this helps.
Sally