1. List the stressors starting with those issues that are most intense. Develop a plan of action to address the sources of stress through a procedure or system.

2. Meet regularly as a team to refine systems and procedures that continue to cause stress.

3. Clearly define staff roles and responsibilities.

4. Train your team to ensure that they can succeed in your practice.

5. Establish work schedules that are compatible with demands and responsibilities on the job. If “Julie” is responsible for delinquent account calls, but never is allowed time or a quiet space to make those calls, she cannot fulfill her job expectations. Make adjustments so employees can carry out the duties they are assigned.

6. Improve communications. If you are stressed out because cancellations and no shows have been on record pace the last few months, rest assured your team is worried too. Talk about the situation as a team and together develop strategies to address it.

7. Take time out for fun – an afternoon at the movies, the zoo, or a long lunch. A little fun can go a long way in reducing stress.

It’s understandable that the hiring doctor wants to ensure that a new doctor treating his patient base is well prepared. After all, the hiring doctor likely has a long and valuable history with his/her patients. Understandably, s/he wants to ensure that they will be cared for in the manner to which they’ve become accustomed.

Additionally, it will serve you well as a new hire to work with an experienced dental assistant. In addition to her/his clinical background, an experienced assistant likely has worked within the practice for some time, and knows the patients. S/he can be an excellent resource in helping you quickly build rapport with patients. Moreover, experienced assistants can be a wellspring of information with regard to proper record keeping ensuring and that you follow the established protocols in your new office.

1. Generate a report of patients due for recall from today’s date to one year from today. Indicate that you are seeking to identify all patients with and without appointments on the report.

2. Tally the number of patient records in the computer system and divide that by the number of patients in the recall system. For example, if there are 4,759 patient records on file and 1,737 patients in the recall system, patient retention would be at 36%.

3. Now subtract the number of active patients from the number of total patient records in the system. Using the example above that number would be 3,022.

4. Divide that number by the number of months the records represent. For example, if you believe that active charts represent the period from 11/09 through 2/13 that would be 39 months. In this scenario, the practice is losing 78 patients per month.

Obviously the patient base is shrinking. Now what? For starters, don’t hire a full-time associate. Instead, implement a patient retention program and look carefully at clinical efficiencies. When it comes to clinical efficiency it can never be compromised, but it can almost always be enhanced.

It’s time to make the schedule your servant and not your master, which means scheduling to meet daily production goals, NOT scheduling just to keep the doctor and team busy. Establish a realistic financial goal for your practice; let’s say $700,000 in clinical production. This calculates to $14,583 per week (taking four weeks out for vacation). Working forty hours per week means you’ll need to produce about $364 per hour. If you want to work fewer hours, obviously per hour production will need to be higher.

Use the formula below to determine the rate of hourly production:

1. The assistant logs the amount of time it takes to perform specific procedures. If a procedure takes the doctor three appointments, she/he should record the time needed for all three appointments.

2. Next record the total fee for the procedure.

3. Determine the procedure value per hourly goal. To do this, take the cost of the procedure, for example $900 for a crown; divide it by the total time to perform the procedure, 120 minutes. That will give you your production per minute value – $7.50. Multiply that by 60 minutes – $450.

4. Compare that amount to the doctor’s hourly production goal. It must equal or exceed the identified goal.

5. Start scheduling to meet that goal every hour of every day.

Instead of answers to problems, you hear the chorus of excuses. “I thought she was taking care of that. Oh, I didn’t realize that. When did we start doing this? Uh oh, how did that happen?” Not because your team is incompetent or unwilling, but because there are no real expectations, there is no delineation of duties, and there are no real measurements of performance. No one is taking responsibility or genuine pride in the outcomes of any one system because they are not allowed to do so.

You cannot ignore solid management practices or human nature for that matter. If staff are simply expected to “fill in” wherever they are needed, no one has the opportunity to take ownership, to shine because the focus is merely on getting the job done, not getting the job done well.

Oftentimes, it’s the little things – the seemingly insignificant actions – that make all the difference. Our opinions of each other are often shaped by them. Our perceptions of the products and services we purchase are influenced by them. And our views of the people who are selling or delivering them are directly affected by them. Those seemingly intangible influences that give us a sense or feeling that this business or that office is a quality operation, that those people are truly a caring team, or a trustworthy group. Simply said, it’s the little things that reinforce what your patients already want to believe. They are merely looking for confirmation.

Patient opinions and perceptions are shaped by multiple variables, many of which tend to be subtle and vague. Often it’s the intangibles that have a very tangible impact on your success and practice growth. Want to evaluate the “intangibles” in your office? Start with the obvious – staff attitudes. Conduct regular “attitude inventories.” Evaluate your staff’s routine communication with patients – tone, body language, their command of the English language. If you cringe or bristle, consider communication training for your team. Telephone training and practice scripts ensure that the “little things” don’t derail the big opportunities in your practice.

Similarly, the mid-point in a dental career can bring great uncertainty, many questions, and frustrations. As the financial struggles, personnel problems and patient issues persist, is it any wonder that mid-career dentists find themselves asking: “Is this all there is?” Where’s the excitement, the enthusiasm, the career satisfaction?

Consider your position on this mid-career path. Are you enjoying the view from the pinnacle of success? Or are you frozen in place, stuck somewhere between merely average and truly excellent? And, if you’re not where you want and feel you should be, are you willing to take the necessary steps to change it? If so, the question then becomes, how? Look at those areas most likely to be sending your practice, and consequently you, into a mid-career slump, starting with team education and training. Nothing will stampede over a struggling practice and pound it into further turmoil than lack of instruction. In fact, the single, biggest contributor to practice inefficiency, mismanagement, lost revenues, and career dissatisfaction is a poorly trained team.

In many cases, the six-month visit is the only time the dentist is going to have the opportunity to sit down with the patient and assess not only his/her their oral health condition, but also the individual’s oral health concerns and interests. What do you do during every routine visit to WOW the patients, further educate them on the importance of oral healthcare, and inform them of the services that your practice provides? Anything? In about eight months, you might be wondering why you haven’t seen this or that patient in your practice for a while. Can you figure it out? Maybe they were tired of being treated as simply just another “routine transaction.”

You and your team advertise your dentistry. If you’re selling smiles, everyone on your team, including you, doctor, should wear the beautiful smiles that excellent dentistry can create.

However, if the employees are thinking like leaders of their respective areas, if they are trained to understand how the practice systems are supposed to work, they become instrumental in the practice’s ability to move forward and grow, rather than always looking to the dentist for the answers to the questions or the solutions to the problems. Oftentimes, when given the opportunity, employees can be your best source for innovative solutions to increasing efficiency, improving customer service, and reducing costs.

Working in a dental office isn’t the type of job in which you are just another cog in the wheel. Rather, this is one of the best places where employees can really shine, provided they are given and subsequently seize the opportunity. We’ve found one of the fundamental steps that practice owners can take to move the team toward thinking like leaders is ensuring that they understand that they truly do have a stake in the success of the business.

Helping employees to achieve an ownership mentality begins with asking a few basic questions. Such as, what they would do if they were in your shoes. What would they change to help the practice provide better customer service? What processes would they adjust to help the practice save money? What steps would they take to help patients move forward with treatment?

Remember, you have employees, now make them a team of solution-oriented problem solvers.