Consequently, these micromanaging doctors are stressed out – working and working, yet never able to actually get ahead. Forget quality of life, forget balance, these docs are living their jobs. Like most micromanagers, they tend to confuse activity with accomplishment and consequently create bottlenecks of inefficiency. Even more frustrating for these dentists and their staff is the fact that they are quite capable of thinking strategically, but they simply cannot bring themselves to relinquish control. They will not allow others to problem solve, and they consistently second-guess decisions. However, if the practice is going to grow and truly succeed, the doctor simply must let go. But how do you bring your micromanaging dentists to relinquish a few of those tightly held responsibilities?

Number one: Don’t try to change them, only they can do that. Instead, work with what you have. One of the greatest needs your micromanager has, outside the need to feel needed, is the need to know. Perhaps your micromanaging dentist really wants more time for treatment planning to encourage greater case acceptance, but at the same time insists on giving all patients their post-op instructions, which only puts everyone behind schedule. Develop a detailed step-by-step plan that outlines how you could help the doctor with this duty. Explain to the doctor that you would like to handle this for her/him in a way that s/he will be completely comfortable and confident that patients receive the post-op information they need.

Studies show that after only 17 seconds, callers on hold become annoyed. How many patients have you irritated today? The patient is far more understanding if the front office employee explains why the patient is being asked to hold and provides the estimated time required. Knowing beforehand how long they can expect to wait reduces the chance of annoyance. Another option is to offer to call the person back within a brief and specific time period.

Do you provide patients information while they are on hold?

Educating the patient is essential in reinforcing the importance of professional dental care as well as informing patients about other services the practice provides. Use specially developed informative messages to tell callers about you, your team, and the services you provide. “On-Hold Messaging” allows you to choose specific messages for your needs such as promoting veneers, or porcelain inlays, or the importance of implants. You have the flexibility to change your message as often as you like. Most important, studies show callers will happily wait on-hold for more than three minutes if they are listening to useful information.

When you’re talking on the phone and a visitor walks in, who gets priority?

The patient who kept their appointment and is waiting to be greeted gets your attention. That means you need to interrupt the caller. The quickest way to get that caller’s attention is to say their name. “Mr. Smith, I have a patient who just walked in, may I ask you to hold for a moment?” Wait for their agreement. Then acknowledge the patient, tell them you’ll be a moment and wrap-up your telephone conversation.

Is what I am saying true? If not, it’s gossip. If I am not sure, it’s gossip.

Could it harm another person? If so, it’s gossip.

Is it necessary information? If not, it’s gossip.

How would I feel if someone made these comments about me? If I would be hurt, it’s gossip.

Would I be comfortable if every person in the office heard me say these things? If I would be embarrassed or ashamed, it’s likely gossip.

Is this conversation consistent with my personal values and professional standards? If you feel like you are doing something wrong or discussing something that can only be whispered, it’s likely gossip.

After 2 rings, patients are wondering if the office is closed. A real human being should answer your phone by the second ring. If you have messages on voicemail during your work day, it is best to determine why the phone is not being answered.

How does your team answer the office phone?

The best approach is, “Thank you for calling Dr. Brown’s office. This is Amy. How may I direct your call?” This standard greeting gives the caller information and provides immediate assistance to address their specific concern.

At what point do you get the patient’s name and phone number?

As soon as the patient is finished talking (never interrupt), the patient’s name and phone number should be reinforced if they have been given. If they have not, name and number should be requested. Obtaining the patient’s name will often secure a commitment from them if they are uncertain about whether they should schedule an appointment. Also request the patient’s address.

Have you ever said, “Please hold” to a caller?

Never put a caller on-hold without asking for their permission and waiting for their response. “Mrs. Jones, may I put you on hold while I check on that?” How many times have you placed a call to a business and been clicked almost immediately into hold? You cannot even utter a grunt without being cut-off. Putting customers on hold without their consent is rude and inconsiderate.

Do you set clear, challenging goals and specific expectations for your team?

Do you explain the “why” behind the “what?” In other words, you don’t just tell employees what to do but you clarify why their responsibilities are important to the overall success of the practice.

Do you monitor the team’s progress in achieving goals through regular staff meetings, system checks, and performance reviews?

Do you celebrate and reward success?

Do you set your employees up to succeed? If so, you invest in training for employees to maximize their potential.

Do you establish clear standards? If so, there is a code of conduct in the office, specific office policies, and business standards that everyone must follow.

Do you communicate clearly and specifically?

Are you are decisive? If so, you make the decisions that have to be made, even when they are difficult.

Is listening a part of your management strategy? If so, you seek input from the team.

Are you honest with your team and do you provide ongoing constructive feedback? Be generous with your positive feedback and constructive with your negative feedback. Positive feedback should be provided in public if possible, and negative feedback should be delivered in private.

For example, the doctor examines a hygiene patient and determines she needs three fillings. The doctor tells the Hygienist exactly how much time is necessary. The Hygienist, in turn, communicates to the Scheduling Coordinator via computer or route slip specifically how much doctor time and assistant time to book. The doctor’s time should be scheduled in one color on the computer and the assistant’s in another. This simple strategy ensures that the doctor is not double-booked.

In addition, the doctor should never be scheduled out more than three weeks, so curb the urge to schedule all of the appointments for large treatment plans immediately. Scheduling the entire plan can overwhelm both the patient and the schedule. Worse yet, “bread and butter” patients are often forced to wait several weeks for routine procedures – not something that many of them will accept on a regular basis.

Keep communications flowing between the clinical staff and business employees throughout the day. Start by reviewing the schedule as a team first thing during the huddle. The clinical staff can advise the Scheduling Coordinator where to place any emergency patients. If there are cancellations, the team can discuss which hygiene patients may be able to receive immediate treatment and which restorative patients may be able to be worked into any openings in the oral hygiene schedule. The dental assistant also can review specifically what procedures are scheduled and set up the treatment rooms accordingly.

Avoid the tendency to engage in “wishful scheduling” in which more time is reserved for the doctor’s “ideal” treatments than the practice has a history of delivering. Rather, calculate the number of crown and bridge units – or other procedures – over the last six months and divide by the number of days worked. Then you can reserve time in the schedule based on the number of units actually performed.

When determining the need for more staff, avoid the pressure to base your decision solely on the obvious. Tasks are not getting done. Dirty instruments are stacking up. Collections aren’t being made. No doubt, the resulting stress is high, and there is an understandable desire to throw more people at the problem, thinking that will solve it. Rather – look at the efficiency of the system. For example, how long it is taking for patients to be handled at the front desk.

If your practice is seeing 15-22 patients per day, which would total 150-220 minutes of patient contact, one person should be able to effectively handle the front desk duties. If the front desk receptionist is spending more than 240 minutes handling patients – or half the day, the practice should consider hiring an additional staff member. One assistant can efficiently maintain two treatment rooms for a general dentist using two operatories and seeing 13 or fewer patients a day. This would include setting-up the room, seating the patient, assisting the dentist, dismissing the patient, and cleaning-up.

Additionally, make sure everyone knows who is responsible for what. Job clarity is essential. Job descriptions are indispensible. Staff are much better prepared to perform their specific job functions when they know exactly what they are and how their performance will be measured.

Remember, throwing more people into an inefficient practice only creates more inefficiency.

1. You have too many employees.

2. The hygiene department is not meeting the industry standard for production, which is 33% of total practice production.

3. You are giving raises based on longevity rather than productivity/performance.

Doctor after doctor after doctor will say they feel like they’re just working to meet payroll, which only continues to escalate while production stays flat or, worse yet, decreases. Establish a compensation policy. The policy states that raises will be given based upon employee performance. Follow these guidelines when dealing with an employee who tells you s/he deserves a raise.

•Don’t give raises because you feel sorry for an employee or are afraid they won’t like you if you don’t give in.

•Don’t answer a request for more money with comments such as: “I can’t afford it right now.” “You haven’t been here long enough.” “I need to be fair to the others.”

•Do ask the employee to provide sound business reasons for why they should be paid more.

•Do ask them to provide a report on recent problems/issues and how they addressed them or new responsibilities they’ve taken on since their last raise.

•Do ask them to explain in writing what they have done to increase revenue, cut costs, and/or save time.

•Do tell the employee what is expected of them. A job description is essential.

•Do inform the employee of how you will measure their performance.

Under no circumstances can raises be given if the practice is losing money.

Employees must know what is expected of them individually and as a team. They cannot be expected to function effectively or cohesively without clear job descriptions and performance objectives. In addition, they must receive regular ongoing feedback in order to make corrections in systems and continuously improve and grow as contributing members of the team.

Take these steps to manage conflict constructively day-to-day before it burns both the doctor and staff:

•Set aside time to address matters that are causing conflict.

•Focus on systems and what is or is not working in the systems rather than on the people. For example, what steps does the practice need to take to ensure that the schedule is booked correctly to achieve specific production goals.

•Address sources of day-to-day conflict during the daily huddle . For example, if the clinical team wants emergency patients placed at certain times they must tell the scheduling coordinator so that the coordinator is not picking and choosing based on what she/he thinks will work.

•Avoid the urge to react emotionally and judge, criticize, or attack.

•Focus on addressing the issue rather than proving who is right or wrong.

•Focus on the desired outcome for the practice as a whole.

•Establish clear standards for professional office behavior. Do not tolerate destructive personal attacks among team members.

•Establish clear office policies and follow them.

•Take time to better understand each other’s personalities and how different personality types communicate.

Certainly, as long as there are people working together there will be conflict. As destructive as conflict can be, if it is managed, it can become a constructive tool in moving the practice and the team that much closer to achieving overall goals and objectives

Patients that have not paid their bills should be notified 30 days after services were performed. Messages should be polite and courteous and they should be customized for the specific patient. The more personal the message, the more effective the communication will be. For example:

Dear Ms. Wheat, (You can use the patient’s first name if you know him/her well and they have been a patient for many years – Dear Jennifer, …)

We wanted to alert you that we did not receive your payment on March 15 as requested. If you are experiencing financial difficulty, please contact Peggy in our office. Otherwise, we would appreciate your prompt attention to this balance by sending payment before April 6.

Before contacting patients, do your homework. Review the account history. Confirm that there is not an insurance issue that might be delaying matters, and make sure the practice is not in error. Never apologize for requesting payment. A dental practice is a business that cannot effectively deliver necessary services to patients without cash flow.