Importance of Professional Business Training
Professional business training for the doctor and the business team is necessary for the success of the dental practice.
After many sleepless nights and thousands of dollars, Dr. Quandary (based on an actual case study – not real name), with the help of an accountant, an attorney, a dental business consultant and banking authorities, saved his practice from a total meltdown. “Everything was fine for many years and when Dorothy retired, I hired Judy. She came with glowing references and I was relieved that things would continue as before.”
Judy was a dental assistant without any formal business training. She was liked by the dental team and loved by the patients. Her temperament personality type was a positive factor in developing friendships with patients, but was a detriment in developing business systems to promote the success of the practice. After several years, she could no longer keep up the balancing act of unpaid insurance claims, overdue accounts receivables and bouncing checks, so she just didn’t show up for work one day and never came back.
In the beginning of Judy’s employment, she was instructed to do just as Dorothy did and Dorothy spent a couple of weeks showing her the daily routine of the front office. Judy mastered scheduling because of her dental assisting background and her skills were welcomed by the doctor, dental assistant and dental hygienists. As long as the bills were paid and everyone received a paycheck, all was well in Dr. Quandary’s dental practice.
As time passed, Judy felt compelled to offer 10% discounts to patients that paid with cash, check or charge, no matter what treatment or products were received. She also offered a 20% discount to seniors. She invited her friends in and let them pay small monthly payments on large balances. Many services were given at no charge if the patient showed a reluctance to pay.
Judy had a difficult time with insurance and posting of the checks. She decided not to use electronic claim filing because she didn’t know how it worked and Dorothy never used it. All claims were filed manually which further slowed cash flow. She didn’t know about the statute of limitations on payment of insurance claims or how the unpaid claims drove up the accounts receivables. She had told patients not to pay until the insurance paid and she would send them a statement. As the unpaid claims piled higher so did the AR. Cash flow began to dry up.
Judy’s responsibilities included not only the practice accounts receivables but also the accounts payables, payroll and all banking responsibilities. Dr. Quandary did not know how bad things were until he was turned down for a loan because of a history of slow payment on accounts and bouncing checks to suppliers.
And what about follow-up on recall and unscheduled treatment? It didn’t happen. The cutesy postcard went out, but if patients didn’t respond, no one called them. Unscheduled treatments remained unscheduled. The number of new patients coming into the practice had been in decline for some time because there were no working marketing systems to replace those patients that had moved, passed away or lost their jobs and insurance. What kept the practice going was Dr. Quandary’s skill in diagnosing and motivating patients to accept mostly single unit crowns, fixed bridgework, implants and other restorative procedures.
Was the failure of Judy in her position entirely her fault? Complicating matters was the fact that Judy did not have a written job description and clearly defined areas of accountability. As the dentist CEO, Dr. Quandary had relied fully upon Dorothy, who had gained his trust over the years. He gladly passed that torch on to Judy without question as to her ability to do the job correctly. He never saw it necessary to know what was going on in the business office. He had never had dental business training, so he did not have first-hand knowledge of the mistakes that were being made every day by Judy. Ultimately, it was his responsibility to see that his business had systems in place to prevent a catastrophic loss.
Prevention is a key word in dentistry because as dental healthcare providers, we know what happens when there is neglect in oral hygiene practices and avoidance of necessary maintenance and repair. Prevention is also the key to good business practices. The above case file scenario could have been entirely prevented if Dr. Quandary had known how to successfully manage the business side of his dental practice, and seen that those who work in the business office need to be trained and have job descriptions that clearly define their accountability to the success of the practice.
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