Don’t leave the schedule to creative interpretation. Scheduling time should be communicated clearly to the Scheduling Coordinator. This basic yet commonly overlooked detail ensures the person in charge of making or breaking your day isn’t forced to guess how much time a procedure will require.
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.
Dentists often are pressed into carving more out of the profit pie to serve up another employee that will further enable an inefficient staff to continue their ineffective operations.
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.
There are three common reasons why dentists find themselves treading the waters of financial crisis:
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.
Conflict typically is rooted in system breakdowns and a general lack of communication – employees do not know who is responsible and accountable for which systems. Conflict can be minimized significantly when individual team members are given clear information, defined responsibilities, and are held accountable for specific outcomes.
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
Many employees cringe at the idea of contacting patients that are delinquent in making payments, because they believe that it will require some sort of nasty confrontation. In reality – kindness, compassion, and clarity are the order of business for this task. Here’s how:
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.