All THIS! And I only Have to Work until I’m 95

Sally Mckenzie, CMC
President
McKenzie Management
sallymck@
mckenziemgmt.com

      Too many dentists are signing away their life savings as well as their lives for that exclusive, gorgeous office they’ve always dreamed of and simply cannot afford. Most convince themselves that the lure of the space alone will cause patients to spontaneously appear and schedule full-mouth reconstructions.

When the illusion evaporates, many doctors are stunned by the harsh reality that the bigger, better space doesn’t automatically translate into greater production. Unless ... you develop a plan for how

you will attract and keep new patients as well as improve treatment acceptance among current patients. As tempting as that dazzling new office may be, don’t sign on the dotted line until you have the collections to pay for it or a solid plan for increasing those collections.

If you’ve already signed away the next 30+ years of your life and handed over your retirement savings for a down payment, grab on to a lifeline and take these steps:

Boost Collections

• Expect full payment at the time of service for all procedures that are under $200.
• In lieu of extending credit to patients, partner with a patient financing company, such as CareCredit. Offering payment options for patients not only allows you to collect what you produce, but production also will go up if patients have a means to pay for procedures they need and want.
• Consider offering a slight adjustment in the fees, such as 5%, for more costly procedures paid in full. Refer to this as a bookkeeping adjustment not a discount.
• Require insured patients to pay a portion of their payment responsibility when services are rendered.
• Do not allow post-dated checks. These amount to lots of money in a drawer and not in the bank.
• Give patients the opportunity to pay in full within 30 days before assessing a financing charge on the account.

Consider Raising Fees

• Evaluate the time required for each procedure, fixed expenses necessary to run the office, variable expenses such as supplies and lab fees, and income required per hour to compensate yourself.
• Establish a standard fee schedule for each service.
• Increase practice fees 5% yearly or twice a year at 2% and 3%.

Work the Recall

• Make a designated number of patient phone calls each day.
• Schedule a specific number of patient appointments.
• Ensure that a precise number of patients complete treatment.
• Schedule so that the hygienist achieves a specific daily or monthly financial goal – at 3x their daily wages.

Market Services to Existing Patients

• Educate patients on the services your office provides, including cosmetic dentistry.
• Use before and after photos to show patients the benefits of elective procedures.
• Give patients brochures and information about your services; don’t just set materials out in your waiting room.
• Provide excellent customer service.
• Call patients at the end of the day to see how they are doing and answer questions.
• Send a small gift and thank you note to patients referring new patients.

Consider Renting Space in the Office
Consult your attorney for necessary legal guidance, but consider having the renting dentists pay a specified amount each month or a percentage of his/her production or collections. Be sure the renting dentist represents your practice well and maintains an equally high standard of care.

If you have any questions or comments, please email Sally McKenzie at sallymck@mckenziemgmt.com.

Interested in having Sally speak to your dental society or study club?
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Tech Tips For Today!

Designed to improve management techniques through your technology platform

Mark Dilatush
VP Professional Relations
McKenzie Management
mark@
mckenziemgmt.com

      Last week, [see article], I discussed how to close all of the “cracks” in your scheduler. Even if it helps your practice reschedule just one more patient per month, it will be worth the small amount of effort to learn those features of your software.

This week, I want to focus in on some of the “little things” your software can do that make a big difference to your patients’ perception of the service level in your office.

A few of the “little things” ...

Step #1
Most, if not all practice management systems will print a merged letter of some kind. Some systems require you to use a word processor like MSWord, while others give you the choice of printing directly from their software or using a word processor. The first step is to uncover all of the different ways you can use your system to generate a “merged” single letter to a patient. A “merged” letter is a document that automatically places the patient information (name and address usually) in the correct position of a letter.

Step #2
Print all of the letters that come with your practice management system. I know some of them look kind of “hokie”, so what! Print them anyway. Create a pile of all the patient letters your system has inside. Bring the pile of letters to a team meeting and ask the team to review them. You will end up with letters you can use right away, letters that need to be altered to fit the practice message, and letters you would never send one of your patients. Alter the letters that need to be changed to fit your practice message.

Step #3
Almost every letter has a specific purpose. With every purpose is a logical time to remember to generate the letter. For instance, if a new patient calls in and books an appointment – that “logical time” is a good time to fire off a letter! Here are some examples ...

Welcome to the office letter – new patient schedules

Overdue balance letter – 1st phone call has been made with no response

Thank you for referral letter - Patient notes on their med history form that they were referred by another patient of record.

Excused absence – Patient requires one after treatment for work or school

Overdue recall – You are at the end of the physical (phone call) follow up cycle

Patient referred out – Patient takes home full contact information for the office you referred them to along with their return instructions

Patient referred in by medical/dental professional – Initial referral recognition goes out accompanied by recommended treatment report

Professionally referred patient completes treatment – Treatment status letter goes out

And so on, and so on ...

Step #4
If you do Step #4, I will be MOST impressed. For every “event” that should generate a letter, go into your practice management system and tell it to remind you and your team members to send the letter! Many of the practice management systems have “flags” or “alerts” that you can set up to automatically prompt the user. If your system has this feature, this is exactly what this feature was designed to accomplish (among other things).

Keep the letters flowing out of your office. It literally takes seconds to generate a document. You can pile them up and fold them up and stamp them all at the end of every day. When your dental practice was just starting, I bet you crawled all over each other to do the “little things” that would endear your new patients to the practice. Why stop doing them? Marketing to attract new patients is expensive. Keeping the patients you have and making them your advocates in the community is fast and inexpensive. Hey, it’s your dime!

I welcome any and all readers to email me with specific questions, problems, requests and challenges. Who knows? Maybe your inquiry will lead to a new Tips For Today article! Don’t worry, your inquiry will remain anonymous unless you want credit for the question.

Interested in having Mark speak to your dental society or study club?
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Hygiene Time Savers

Dr. Allan Monack
Hygiene Clinical Director
McKenzie Management
allan@mckenziemgmt.com

         Do you realize that making your hygiene department more efficient with time saving techniques, you could possibly add up to two more patients in the daily schedule? What would that mean to a practice? An opportunity to service more past due patients and increase practice revenues just to name a few. Organizing the hygienists daily routine to work smarter, not harder not only makes life easier for the hygienist but benefits the patient who now is sitting in the treatment chair less time. Implementing a well

thought out plan with the following time savers will increase production and reduce stress on the hygienist and doctor.

Time Saver #1 If you are not utilizing ten minute interval appointments for hygiene patients, convert your scheduler as soon as possible. This alone can save five to ten minutes per patient chair time. Some 60 minute patients may be able to be done in 50 minutes, for example.

Time Saver #2 Promise your hygienist that you will be available to perform the examination during the patient’s allotted appointment time. Your ability to accomplish this is easier than you think. Expand the time you have to do the exam. I recommend that you examine the patient after the radiographs are ready to view and all preliminary evaluations are completed. These include intra-oral photographs, periodontal probing, caries detection, defective restoration evaluation, cosmetic considerations, and orthodontics. The patient should be informed of these preliminary findings. I will discuss the important part of the recall visit in a future column. If there are two hygienists seeing recall patients, it is best to perform both examinations before returning to your patient. It takes less time to get up from your operative patient one time than… up and down and up and down.

Time Saver #3 Make sure the currettes and scalers are sharp and a sharpening stone is on every hygiene setup. Utilize high volume suction and water spray to cleanse the oral cavity. This will minimize the biggest time waster, the swish and rinse procedure.

Time Saver #4 A new type of prophy angle now available called “The Twist“ practically eliminates splatter and the constant dabbing and dotting the prophy cup into the prophy paste. It takes a change in the traditional mind set on the way you’ve been taught the polishing technique. Once the technique is mastered, it will reduce approximately five minutes off the polishing time. There is a reduction in splatter and the prophy paste stays in the prophy cup during polishing. For more information or to order you can contact the manufacturer, “Twist2It” at 1-877-PROPHYS.

Time Saver #5 The best time saver I have found is the addition of an apprentice. This hygiene assistant job description would entail breaking down treatment rooms, sterilizing instruments, and setting up the operatory for the next patient. This person could be responsible for up to four operatories including seating the patient, developing radiographs, assist in charting, and escorting the patient to the financial coordinator. With the amount of time required for infection control this position becomes an integral part of the team saving an enormous amount of time for the hygienist and the doctor’s assistant. When considering a hygiene assistant their salary plus the hygienist’s salary combined should not exceed 33% of the production of the two employees.

In order to implement these time saving ideas, proper planning is necessary. Begin by having a team meeting to discuss implementation. Encourage your team to develop other ideas. Empower them to create an efficient and productive office. A well thought out plan will increase production, provide better customer service and keep your schedule on time. Now you have some of the best time savers that will increase your hygiene production with less stress and better patient care.

Hi Sally,
Recently I've run into a problem with my recalls as a number of them say they want to come but tell the receptionist that I’ll come when I'm ready. How do we rebook these patients and what is a good way to say it to them?
Sincerely,
Dr. Bill

Dear Dr. Bill,
Having done a lot of research in this area for our clients, the patient saying “I will call you back” is their way of gaining control of the conversation. If we allow them to have it, we lose. I advise our clients to come back with, “There’s no problem for me to call you in two or three weeks. Would that be convenient?” So, I am giving them a 2-3 week offer to keep the monkey on my back. If the patient says “No.” then I come back with an offer of 2-3 months to call them back. “Mrs. Smith, I understand how things can get hectic with day to day things. Would it be better for you if I called you back in two or three months?” The operative word here is “months”. If the patient comes back and says “NO!” then say, “That’s fine, Mrs. Smith. We will have your records here in safekeeping till you decide the time is right for you to come in. If there’s anything we can do in the meantime, again my name is Sally and our number here is 459-4938.”

At the conclusion of that conversation, a confirmation letter is sent to the patient confirming that we care about their dental health and want you to know that your records will be kept here in safekeeping until you decide the time to return. I then recommend going into the “benefits” of why they should return, regarding gum disease, etc. I also enclose a business card with our phone number. I would not call this patient back but once their next recall visit is due, say 6 months later another written correspondence is sent.

I have written a book about this,
How To Have a Successful Recall
System that you might be interested in. You can view it on my web-site,
http://www.mckenziemgmt.com/
hygienemanagement.html or you can call my office 1-877-777-6151 and ask for Sara.
Good luck,
Sally

For more information, email info@mckenziemgmt.com
or call 1-877-777-6151