Termination and Turnover Hurting Patient Retention
Office Manager Training Case #OM498
“Our practice has had a lot of turnover the past couple of years.”
“Nancy” (names have been changed) explained the challenges her practice was facing when she came to McKenzie Management for Office Manager Business Training. The doctors discovered the practice had been embezzled by the previous office manager, and cash flow was poor when Nancy took over. The practice was doing a lot of marketing and getting many new patients, but there was not a proportional number returning to the practice at recall. “Why is that?” Nancy asked.
Unfortunately, the former office manager was a favorite of the patients and had been employed there for many years. This manager took it upon herself to take the patient contacts and call them to explain why she left. The reasons she gave were not true, so she was asked to stop. To add fuel to the fire, the owner doctor was losing her patience with the underperforming dental assistants and couldn’t control her disappointment in front of the patients.
They are “empty heads” said the doctor regarding the dental assistants working in the practice. “The job pool is very poor in this area and by the time I recruit, interview, hire, and train a replacement, it’s a huge emotional and financial toll. Sometimes the person I hired is even worse than the one I let go.”
The doctors were doing what they could to try and train the dental assistants and help them achieve better performance. But the dental assistants knew the doctors would be hard pressed to find replacements for them, especially with the low pay they were receiving.
These stresses and/or fears can lead to resolution paralysis, or you put up with the poor performing employee for much longer than you should. Too many employers allow themselves to be held hostage by underperforming employees. This is not a winning situation for anyone involved.
Patients see, hear and feel the turmoil in the practice. They are not there every day and haven’t gotten used to it like the doctors and staff have. When things are said that patients should not hear, that is often a reason why they don’t return. In this office, there was also no one calling patients to make unscheduled appointments for recall or treatment planned. The combination of a bad patient environment coupled with a lack of follow-up equals poor retention.
The morale of the staff often reflects your attitude. If you are unhappy, chances are they will be unhappy too. If you project a positive mental outlook, they are likely to respond the same way.
On analysis, it was discovered that none of the employed dental assistants were certified. They were all trained on the job and were making the lowest wage in the office, and probably also in the area. They hadn’t been dental assistants long enough to know whether this was a career choice for them. When a dental assistant quit or was terminated, it was because more was expected of her/him than they had the experience or training to deliver. The doctors were not willing to hire a seasoned RDA or CDA who was a career professional and had the skills to do temporary crowns and other expanded duties.
Performance is a function of both ability and attitude. You can have someone with a great attitude who lacks ability; you can have someone with a bad attitude and great ability; it is great to have someone balanced between the two.
People with low ability and/or poor attitude may have been poorly matched with the job in the first place. They may be in a position that's too demanding for them. Providing training is necessary when you hire below the skill level you need.
Focus on the resources provided to do the job. Does the employee have what is needed to perform well and meet expectations? Ask the employee for thoughts, ideas, and/or suggestions that will bring about improvement. You can never have a stable practice that keeps patients when you have chaos and resentment in the team.
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