When you join a practice as an associate, don’t be surprised to find the supervising doctor placing limits on the types of clinical procedures you can perform early on. This is a sensible move and you would be wise to embrace it. The fact is, the hiring doctor has not seen your clinical skills in action. S/he needs to assess your clinical abilities, particularly if you are a recent graduate from dental school. This is an excellent opportunity for you to learn and grow as a practicing dentist.

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.

Before considering an associate, make sure you have enough patients. Measure the number of truly “active” patients. Start with key computer reports, including the past due recall report, the missed appointments report, and the unscheduled treatment report.

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.

I have to admit that I really like the idea many dentists have of “cross-training.” Everyone on the team covers for everyone else. It’s a nice warm and friendly notion that team members just automatically step in and help whenever the need arises. But when I try to gather more details on how this works in their practices, what the protocols are, what training took place to prepare the staff to just “step in” when necessary, the answers are typically long on generalities and short on specifics. One of my favorites is, “Well they just do what needs to be done.” Oh, really? The fact is that when everyone has their hand in everything, no one is accountable for anything.

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.

“Act as if what you do makes a difference. It does.” That is one of my favorite quotes from American philosopher William James.

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.

Eighty percent of practices are losing more patients than they are gaining new patients. It’s easy to assume that patients you’ve had for years will continue to return, and it’s also easy to fall into the trap of thinking that those patients will raise questions and inquire about treatment options without your prompting. What happens far too often is teams fall into the “Transaction Mindset.” The patient is coming in for a routine oral hygiene appointment and exam. Everyone clicks into autopilot, after all this is merely a routine transaction. Wait! Wake up! This is one of only two contacts your office will have with that patient in the next 12 months. This isn’t a mere transaction. It’s your brief opportunity to strengthen your relationship with this patient.

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.”