3.19.10 Issue #419 Forward This Newsletter To A Colleague

Don't Increase Staff Until You Do This
by Sally McKenzie CEO
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The schedule is fuller than it’s been in months. The phone is ringing. The staff doesn’t have time to stand around and place bets on how many patients will no-show today. And you, doctor, are ready to leap for joy as yours is among the many practices that are starting to see the economic clouds of the last several months show signs of parting. The irony of it all, as the cliché goes, is that you could cut the tension with a knife. The team is feeling the stress of increased busyness. Consequently, instruments are piling up. Appointment confirmations are falling by the wayside. And you are starting to hear those familiar rumblings, “Doctor, we simply cannot get everything done without more help.” It would be music to your ears if it wasn’t a potential major blow to your wallet.

As the economy slowly improves, the last thing you want to do is create greater overhead pressure on your practice. It’s likely that over the last few months you’ve trimmed staff or staff hours. Before you rush to line your employment rolls again, take a close look at the effectiveness of your systems. This is the ideal time to consider 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.

Now, you may evaluate your systems and still feel that it’s time for more help. If so, make sure you understand the impact on your bottom line. 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 may increase gross wages to 27%; this would put your practice well over the industry standard for payroll.

If you still feel that you absolutely must increase staff, take steps to ensure that your investment pays for him/herself. Your team may be clamoring for a “helper,” but what you want is a “producer.” For example, if the new hire is a patient coordinator who will increase practice revenues by making sure appointments are kept, that shiny new face in the office can enhance practice production – a definite plus. Or if the individual is a hygienist who will enable the practice to meet the demands of a growing hygiene schedule – provided it’s not riddled with no-shows and cancellations, the investment is a wise one and the negative financial impact should only last for about 60 days. Beyond that, production should increase, and the wage percentage of gross income should return to the normal range of 19%-22%.

Additionally, there is no better time than now to cultivate a “producer mentality” among the team. For example, if the doctor is away at continuing education, the assistant may have time to pick up the phone, follow the appropriate treatment presentation script and book unscheduled treatment – helping the practice meet monthly production goals. To reinforce the “producer mentality” encourage employees to develop producer-focused job descriptions, incorporating into the description exactly how the role fits into or contributes to the success of the entire practice. And ensure that before you rush to hire another person, you’ve fully maximized both your practice systems and your team.

Interested in speaking to Sally about your practice concerns? Email her at sallymck@mckenziemgmt.com. Interested in having Sally speak to your dental society or study club? Click here.

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