5.11.07 - Issue # 270 Forward This Newsletter To A Colleague

Nancy Caudill
Senior Consultant
McKenzie Management
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Are You Coordinated?

A McKenzie Management Case Study

Dr. Delbert Hughes – Case Study #28

“How do I hold my business staff accountable?  I work side-by-side with my clinical staff so I know what they do all day.  I have no idea what my front desk team does!”

OK…I can see why a doctor might wonder this kind of thing.  Not only does the tooth fairy bring money for teeth left under the pillow but she also answers phones, files insurance, schedules appointments, makes plane reservations, keeps up with the doctor’s meeting schedules, cleans out the “frig” in the staff lounge, replaces the toilet paper in the patient restroom, etc.  Yes, I am sure that he wonders what they do all day long.

Dr. Hughes’ practice demographics

  • 15-year old practice in the same location
  • 2 outstanding hygienists working 4 days a week each (total of 8 days of hygiene)
  • 2 excellent chairside assistants
  • 2 wonderful ladies at the front desk

The Business Team

  • Joyce – has worked for Dr. Hughes for 12 years and knows everyone by name.  These are her duties, as she tells me:
      • Answers phones and schedules appointments
      • Calls insurance to check eligibility for new patients
      • Calls insurance companies to check on unpaid claims
      • Sends out monthly statements
      • Files charts
      • Recall follow-up
      • Confirms doctor and hygiene appointments
      • Posts payments and prepares deposit
      • Etc., Etc., Etc.
  • Kathy – has worked for Dr. Hughes for 3 years and is extremely efficient and computer savvy.  These are her duties, as she tells me:
      • Answers phones and schedules appointments
      • Calls insurance to check eligibility for new patients
      • Calls insurance companies to check on unpaid claims
      • Sends out monthly statements
      • Files charts
      • Recall follow-up
      • Etc., Etc., Etc.

I assume that you get the picture.  They both do everything and neither one of them is held accountable for any of the tasks.  Now don’t get me wrong…it was not their fault. 

What is the Purpose of a Job Description?
The concept of “job descriptions” is misunderstood by many doctors and staff. The first thought is that it means that certain people are capable of doing only certain things and no one else should know what the other does. This is not true in most dental offices. Because the staff is usually limited to one – three people, it is necessary that everyone is familiar with what the other does. Then, you ask, what is the purpose?

A-C-C-O-U-N-T-A-B-I-L-I-T-Y

Where certain tasks are assigned to specific team members, it means that they are “responsible” for getting the job done and done correctly.  They can certainly “farm out” the task to another team member that is willing to assist when they have time.  However, the owner of the task is ultimately responsible.  If the person they “farmed out” the task to performed it incorrectly or incompletely, the doctor looks to the responsible party for correction.  No more, “I don’t know, I didn’t do it.”

How to Assign Job Descriptions:
Let’s take Joyce and Kathy.  After I interviewed both of them and having reviewed their temperament type, this is what I discovered:

Joyce was Extroverted.  She enjoyed talking with patients and knew how to make them feel welcome and comfortable.  She was also a Thinker.  She made her decisions on how she felt about situations and tried not to allow her feelings to get in the way of the systematic way of doing things.  Her new job description of Schedule and Financial Coordinator included the following tasks:

  • Scheduling the doctor to a daily gross production goal every day
  • Confirming the doctors appointments 1-2 days in advance, depending on the appointment
  • Preparing the doctor’s charts each day, as well as the routing slips
  • #1 to answer the telephone and route the call to the appropriate person
  • Checking patients in and out
  • Presenting treatment plans and making financial arrangements
  • Call past due accounts when necessary (since she was the one that made the arrangements in the first place and felt more comfortable talking with the patients)
  • Balancing the charges by provider at the end of the day
  • Other daily miscellaneous tasks

Kathy was Introverted and a Feeler.  She was better suited and felt more comfortable “behind the scenes” and not multi-tasking.  She preferred to complete a task before starting another one.  She didn’t feel comfortable talking with patients about their finances because of her own.  She was extremely dedicated to her job and was proficient at what she did.  Her new job description of Insurance and Hygiene Coordinator included the following:

  • #2 to answer the telephone and route the call to the appropriate person
  • Scheduling the two hygienists to a daily gross production goal every day
  • Confirming the hygiene appointments 2 days in advance
  • Preparing the hygienists’ charts each day as well as the routing slips
  • Maintaining the recall system
  • Following up on all outstanding insurance claims (she was fine talking with insurance companies)
  • Preparing the statements weekly – any particular questions went to Joyce
  • Posting payments daily
  • Preparing the deposit daily

When anyone in the office has a question (including the doctor), they know who to go to for the answer for accountability.  Monthly statistics are presented to the doctor and team by Joyce and Kathy of their own “department”, illustrating their performance and ability to reach designated goals. 

Conclusions:
Dr. Hughes understood now why it was important to “coordinate” his business staff for better performance and, more importantly, accountability.  No more, “I don’t know.” or “Gosh, Dr. Hughes, I didn’t post payments that day.”

I offered a concept to him:  “If they are performing and reaching goals – the patients and other staff members are happy because they are team players – so what if they spend a few minutes talking about American Idol?  They are coordinated!”

If you would like more information on how McKenzie's Practice Enrichment Programs can help you IMPLEMENT proven strategies….. email info@mckenziemgmt.com.

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