Clinical Efficiency Doesn't Compromise Care
For “Dr. Dial,” the last few years haven’t been great, but they haven’t been bad either. His days are full, but his coffers are not. Dr. Dial is putting in the time but doesn’t see the financial return, and he can’t quite understand why.
The problem is that “busy enough” doesn’t translate into “productive enough.” In fact, the irony is that in many practices even when overall production is weak, the dental teams will feel they are overextended. They are stressed and struggling to keep on track, only to find that the results don’t reflect the level of effort the team seems to be putting in day after day. Understandably, this creates tension, a fair amount of frustration, and finger pointing.
Is it treatment acceptance? Is it scheduling? Is it hygiene? Certainly many factors can and do contribute to weak or uneven production. But one factor dentists often overlook is clinical efficiency. It’s like wallpaper. You walk by it every day but seldom if ever notice the details. Dentist and assistant repeatedly fall into a pattern of performing procedures the same way, giving minimal thought to efficiency. Or they might consider making some changes but believe they’ve adapted well to the “less than perfect” way of doing things. In other words, they know there are other and possibly better ways to operate, but they’ve “always done it this way.”
Then there are the newer dentists who emerge from dental school with little or no training in how to effectively use a dental assistant. Consequently, clinical inefficiencies develop almost immediately. Those inefficiencies grow into work habits that become second nature - so much a part of the routine that they are almost never considered for improvement. The dentist may think nothing of stopping a procedure to adjust the light, or the fact that they have to ask the assistant for specific instruments, or that the assistant is repeatedly stopping the handpiece and craning to better see the procedure. Yet each of these minor annoyances or seemingly insignificant details adds up in time, money, and lower production. If the clinical efficiency is lacking, the procedure takes longer and fewer patients can be scheduled. Consequently, production suffers.
Oftentimes, significantly improving chairside efficiency requires one simple change. Typically, the dental assistant who isn't adjusting the light source as necessary or isn't anticipating the suction needs, air and water needs, or medicament needs is likely not sitting in the chair properly. The assistant must be one head higher than the dentist and there should be a hydraulic lift on the chair so s/he can see into the mouth and properly anticipate the dentist's needs.
Dentists are legendary perfectionists. It's both a great strength as well as a weakness, particularly when it comes to maximizing clinical efficiency. A dentist may change burs five times during one procedure. Every change increases the time necessary to complete the procedure.
Additionally, it is not uncommon for dentists that struggle with productivity to 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. Each of these interruptions equates to clinical inefficiencies, as do slow treatment room turnaround, underutilization of chair-side assistants, and inefficient procedural protocols. The consequence is lower production and greater stress on the doctor, staff, patients, and the practice as a whole.
Then there is the matter of delegation. If you feel you are run ragged day after day, take a good look at the tasks you are performing that should be the responsibility of other team members. Dentists should consider delegating every procedure, patient interaction, and staff issue legally allowable in their state.
Improving clinical efficiency never involves compromising care. Rather, the focus is on improving the delivery of that care as well as fully maximizing each hour of doctor and staff time.
For more information on this topic and for additional Dental Practice Management info, visit my blog: The Lighter Side.
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