'Help' Yourself to High Overhead
by Sally McKenzie CEO
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“Helpers.” Dental practices seem to be fertile ground for growing a proliferation of helpers. Helpers in the front, helpers in the back, helpers after school, helpers in the summer, helpers on the weekend, helpers in the evening. They are sort of like spare parts, providing a nice sense of security. Right there, ready and waiting when needed. They clean treatment rooms, pull patient records, answer the phones, scrub instruments, file, all standard “helper” duties. Where would the dental practice be without “helpers”? Probably enjoying greater profitability for starters. Helpers tend to have vague, unproductive job descriptions. Conversely, producers call past-due recalls, they book the unscheduled treatment, they increase collections. In short, their responsibilities enable the practice to produce.
“Oh Sally, we would be lost without our helper. We are so busy, if we didn’t’ have a helper, well, things would just fall apart.” I know, I know, I’ve heard it before. Dentists perceive that they need a “helper.” They look at the evidence, er, let me rephrase that. They look at the obvious: Insurance claims are backlogged, confirmation calls are forgotten or ignored, dirty instruments are stacking up, collections are slipping, and accounts receivables are gaining. Yep, a helper is the answer – actually it’s the quick and easy way out that will enable the doctor to stave off the staff mutiny for at least a few more months. But this temporary solution has a hefty long-term impact, just consider your budget.
Look at wages paid in your practice including the hygienist’s, but excluding the doctor’s. They should be no more than 19% to 22% of gross income, not including payroll taxes and benefits. If the current gross salary expense is around 22%, adding another person will increase gross wages, for example, to 27%. Maybe you could ask for volunteers on your staff to see who would be willing to absorb 5% pay cut? Or maybe you would just trim your salary back? A drastic thought, indeed, and all the more reason you want to consider a couple of factors before you rush to hire the helper.
First, who’s driving the push for additional staff in your practice? Does your team include a “not-my-jobber” or two who’s inflexible, refuses to step up to the plate, yet constantly makes demands? You know the ones; they wouldn’t answer the phone if their next paycheck depended on it. Make confirmation calls to patients, you must be kidding! Their favorite phrases are, “I don’t have time to do her job” or “Doctor doesn’t pay me to do that” or “That’s not my job.”
Could your existing team actually handle the current demands if you addressed the “not-my-jobbers” who are pulling your productivity down?
Second, is this seemingly perpetual state of busyness a reflection of system inefficiency? Take a close look at streamlining duties and evaluating the time spent on tasks, as well as examining the mechanics and/or the materials involved in performing tasks.
For example, how much time is spent with patients at the front desk? Check in and check out takes approximately 10 minutes per patient. There are 480 minutes in an eight-hour workday. If your practice is seeing 15-22 patients per day, which would total 150-220 minutes of patient contact, one person should be able to handle front desk duties.
If the doctor has 14 or more scheduled patients a day, not including hygiene exams, he/she needs a second assistant. However, if the procedures are streamlined, one assistant can efficiently maintain two treatment rooms for a general dentist using two operatories and seeing 13 or fewer patients a day. Moreover, if your state allows for expanded functions for assistants start maximizing those resources.
Patient dismissal should take two minutes, while disinfection of treatment rooms and cleaning/sterilization of instruments should take less than five minutes.
Next week, if you must hire a “helper” hire the one who will produce.
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