Will You Sink or Swim? Check Your Systems
I shudder when doctors say to me: “I don’t know what I would do without Betsy, she just makes this place run.” Dentists that allow this to happen are setting themselves up for economic, professional, and personal catastrophe. That may sound like high drama, and it is. I’ve seen it happen in too many practices too many times. The last thing you want is a situation in which your professional success or failure is contingent upon the actions of one employee. Every practice must have systems in place to ensure that the business is not dependent on any one person.
It is critical that doctor and staff understand how systems should be performing when measured against industry standards as well as the doctor’s practice vision and goals. For example, there is no industry standard for patient retention, but the doctor can and should set his/her own goal for this. The practice should begin by measuring how many patients it’s losing each month. From there, you can evaluate the various systems, such as recall, that directly impact patient retention and establish realistic goals to improve them.
Collections are another example: the goal should be a 98% collection rate; case acceptance should be at 85%; hygiene should produce 33% of practice production; 80% of emergency patients should be converted to comprehensive exam; and the schedule should have fewer than .5 hygiene openings per day.
Recall is commonly among the weakest systems in practices that are struggling, but unscheduled treatment typically doesn’t come anywhere near passing the “effectiveness test” either. Take advantage of practice management system reports that are readily available, including the Unscheduled Treatment reports. These allow you to see who has unscheduled treatment in the files. In actuality, the unscheduled treatment report is documentation of revenues waiting to be tapped.
With this information in hand, the objective is to get patients back in the practice. This may require a paradigm shift of sorts for your scheduling coordinator because instead of being reactive it requires that person to be proactive. But don’t send her or him out to line up production without a clear and specific plan of action and a well developed script to guide in talking to patients. And remember, this isn’t the sole responsibility of the business staff. As patients return for hygiene appointments, it is essential that both the hygienist and the doctor remind them of the importance of pursuing treatment that has been diagnosed but not delivered.
In addition, take a close look at the Production by Provider Report each month. This shows the number of each type of procedure performed over a specified period of time. Your business assistant should run this year-to-date report every month for each doctor and hygienist, so they can determine how their production compares with the same time periods last year, as well as with production goals that have been established for this year. According to the industry standard, 33% of hygiene production should be derived from periodontal therapy, specifically the 4000 insurance codes such as #4910 and #4341.
In addition, consider new treatment services. Practices that are struggling are likely doing what they’ve always done, i.e. crowns, fillings, and prophys year-after-year. Dentists who are doing interceptive perio, endodontics, veneers, bleaching, and implants not only expand their patient base and improve their production, but they also renew their professional enthusiasm for dentistry.
Additionally, take a close look at your clinical efficiency. We find that many dentists get up from their chair numerous times during patient procedures, or have their assistants leave the treatment room to retrieve items that should have been set up in the first place. Clinical time and motion studies reveal three more reasons for production shortfalls:
1) Slow Treatment Room Turnaround
Finally, give some thought to your fees. Calculate your production per hour (PPH) along with a PPH analysis of every procedure you offer. This is much easier to determine than many realize. Take the amount of your fee for a specific procedure and divide that by the amount of time it takes to do the procedure. That number is your production per minute. Now multiply the production per minute number by 60 minutes. That number is your production per hour (PPH). Once a year, consider implementing fee increases following an analysis of comparable fees in your area.
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