5.14.10 Issue #427 Forward This Newsletter To A Colleague


Nancy Caudill
Senior Consultant
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Sometimes It's Time to Say Good-Bye

Case Study #231
Dr. Barbara Cross

On the questionnaire that our clients complete prior to the initial visit by the consultant, it is not uncommon for one of the requests to read something like this: “Need you to motivate my staff.”

Gosh, I wish I had such powers over people, but motivation must be self-induced. I can shine the light down the path, provide toolboxes, and be a great cheerleader but motivate, I can’t. This same request was made by Dr. Cross when I visited with her. “I feel like my team is in a rut. We are doing the same things over and over again and not making any significant changes for improvement. They need to be motivated.”

So let’s see what is really going on in Dr. Cross’s office.

Practice statistics at the time of my visit:

  • Gross production was unchanged over the past 3 years
  • Production adjustments had increased to over 10%, not including PPO adjustments
  • A/R over 90 days at 34%
  • $13,000+ in outstanding insurance claims over 60 days
  • Net collections 95% of net production
  • Overhead has been slowly increasing 2% a year to its current percentage of 64%

The actual dollar amount is not significant for this article. It is important, however, to note that the practice is not growing financially. Several statistical indicators illustrate that the practice has areas that need improvement.

Step #1 – This Is A Business
After revealing all my practice concerns with Dr. Cross, it was time to share my findings with the team during the presentation. Recognizing that numbers, calculations, percentages, and projections are not always everyone’s strong suit, I attempt to make my information as understandable as possible. My goal is to impress upon Dr. Cross’s team that the practice is a business. No, we don’t sell tires or clothes and our “customers” don’t walk out of our “store” with bags full of purchases. However, the practice is still a business with business concerns such as overhead, profits, losses and the need for accuracy.

Accuracy is important in all phases of the business. The patient’s demographic information must be correct in the computer in order to generate accurate statements, insurance claims and reports. The patient’s clinical information must be charted accurately by the doctor, hygienist and assistants to avoid potential errors today and in the future.

Step #2 – Analyze The Business For Strengths And Weaknesses
Now that Dr. Cross and her team understand all that must be taken into consideration when running a profitable business, information must be acquired, reviewed and analyzed and decisions must be made in order to turn the business around and make a profit. The following topics were discussed:

  • Accounts Receivables
  • Daily Production Goals - based on fixed expenses for the upcoming year (overhead)
  • More Efficient Scheduling
  • Past Due Recall Patients (retention)
  • Improved Hygiene Production

Fortunately, her practice was not suffering from a lack of new patients. Two years ago she had made the leap to digital radiography, thus eliminating patient paper records, and the practice had undergone a complete “makeover” last year so these topics were seen as strengths.

Step #3 – Who Can Do The Job?
As a team, and along with my guidance, Dr. Cross and her team evaluated the weaknesses of the practice. They established production goals based on where they wanted the overhead to be in 12 months in order to receive a salary increase; discussed more profitable ways of scheduling; steps that could be taken to improve patient retention; and developed a periodontal program to better serve their patients.

These discussions evolved into Job Descriptions for the team: a Clinical Coordinator to manage the expenses of the dental supplies, a Financial Coordinator, Schedule Coordinator and Hygiene Coordinator to manage the various tasks in the business area of the practice. Each Coordinator was assigned very specific tasks in order to reach specific goals they established. Now the fun begins! 

This is where the tough get going or the going gets tough. Remember I mentioned that many wonderful team members understand numbers, goals and targets. Other team members can remember every patient’s name, their pet’s name and their telephone numbers. What a gift when used in the right “department” of the business.

Dr. Cross had three wonderful business team members. Due to lack of job descriptions, they all did everything and yet no one did anything specifically.  It was due to no fault of theirs – the doctor never learned in dental school how to run a “business.” Fortunately, however, she knew enough to see that something needed to be fixed, she just didn’t know what it was or how to fix it!

Step #4 – Is The Right Person In The Right Position For The Job?
After spending less than six months working with the three wonderful people in the business department of Dr. Cross’s practice, it was very obvious to the three of them that each had their own strengths and weaknesses. Unfortunately, their own titles and job descriptions did not fit their strengths. They were not achieving their goals, Dr. Cross was not happy, and the entire team was suffering as a result.

The solution?  Match up the strengths of the team members with the job description that works best for them. The Schedule Coordinator and the Hygiene Coordinator swapped places. They realized that one of them was more task-oriented and one multi-tasked much easier and enjoyed the “organized” chaos that can take place in the “hot seat.” The Financial Coordinator recognized that she was not a “numbers” person, which is so very crucial for her position. She elected to attend hygiene school so she could work more closely with the patients, which was her strength.

As the owner of your “business” there are times when it can be very difficult to make the right decision for the entire team and for the business. Analyze your practice to determine your strengths and weaknesses, review the job descriptions of your team and confirm that you have the right people in the right places - everyone will be much happier as a result!

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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