You the ‘Dollar General’ of Dentistry?
The 50th or 60th percentile
doesn’t exactly conjure up images of great success. After
all, in school those percentages would certainly be failing grades.
If your car or computer only worked 50% or 60%
of the time you would promptly dispose of it. If the cardiac surgeon
were successful in 50% - 60% of all cases you wouldn’t hire
him/her for your mother’s bypass surgery. If you were only
being paid 50% to 60% of what your work is worth certainly you wouldn’t
tolerate it … or would you?
reality, many dentists are delivering highly skilled dentistry only
to charge discount store fees. They have anchored
their practices to the dock of poor or mediocre financial return.
doesn’t take a financial wizard to figure out that if fees
– the main artery to your practice lifeline – are getting
the squeeze, everything else is choking as well. Pay raises and
bonuses are gasping, new equipment purchases are practically code
blue, production is non-responsive, and all other systems are likely
flat-lining at best. Yet many doctors do not have a regular
schedule for increasing fees because they are positively
petrified to do so. They are convinced that if fees go up patients
reality, most dental practices have a solid foundation of loyal
patients who trust the dentist and respect the quality of work provided.
It’s not the fees that drive most patients from a
practice. It’s also reality that fee increases do
not go unnoticed. Some patients will comment. Yes, a few may actually
leave, but it will not cause the mass exodus that many reluctant
you want a fair fee schedule, but fair doesn’t mean boxing
yourself into being the “Dollar General of Dentistry.”
If you are concerned your patients do not understand the value of
your services and, therefore, would balk at any fee adjustment,
make an effort at each visit to educate them about
the dentistry you are providing. Clearly explain the procedures,
what is being done, and why it is vital to their oral health and
them on other services the practice provides that could further
benefit both the patient and their family. Supply an itemized
list of the dental care provided. Involve the entire staff
in improving communication and the perceived value of services from
the time the patient walks in the door to the moment they drive
away from the office. You and your team are providing valuable dental
care to each patient and every interaction your team has with patients
should underscore that point.
week, increase fees and improve patients.
you have any questions or comments, please email Sally McKenzie
in having Sally speak to your dental society or study club?
the Patient’s Perspective
a patient, I really do not know if a dentist does good work or bad
work. I always feel good when a doctor relieves pain, but that doesn’t
mean the doctor does good dentistry. How do I decide if a doctor
does good work or not? I don’t investigate the dentist. I
don’t even know what school he graduated from and certainly
where in the class he was rated. I guess it is how he cares and
treats me that really matters.
surveyed a small group of patients who have received treatment from
different dentists, let’s look at different scenarios that
other patients have brought to my attention. To paraphrase, let’s
look at “The Good, The Bad and The Ugly.”
patient woke up one morning in pain. She took some over the counter
medicine, but the pain did not go away. She called her dentist and
asked if she could have the first available appointment.
The receptionist informed her that the first appointment of the
afternoon had cancelled and they could see her at that time. The
patient came in ten minutes before the appointment, was handed some
forms that had to be completed, which she did, picked up a magazine
and waited for the doctor to call her in to the treatment room.
When she realized fifteen minutes had passed her appointment
time, she asked the receptionist when the doctor would
be coming to get her. The receptionist said that he would be right
with her. At thirty minutes passed her appointment, she asked the
receptionist, “Where was the doctor?”
The receptionist replied, “He was in the hallway talking to
a colleague.” The patient knowing no fear of intimidation,
walked into the hall and over to the doctor and informed him that
he was already a half hour late. She said that if his friend were
more important than a patient who was in pain,
she would go somewhere else. The doctor quickly apologized and took
the patient into the treatment room. His excuse was that he didn’t
realize the time when he was talking. He did help
the patient, but the patient never went back to him. She felt that
his patients were not his first priority. Of course,
she also relayed her story to her friends,….at least 10 of
them, which is not good for the reputation of the doctor.
could this have been handled differently? Perhaps the receptionist
could have said to the patient that she would find out what was
causing the delay and thank the patient for bringing
this to her attention. She could have then politely interrupted
the doctor’s conversation and reminded him that he had a patient
in pain in the “waiting” room. He would have realized
that time had passed, would have taken the patient earlier and apologized
sooner. This would also have given him time to apologize to the
other patients who would also be waiting longer for their appointments.
You do not necessarily have to give a reason for running late. Patients
like to know that you are thinking of them. They understand that
a doctor cannot always be on time. Taking a few minutes to go into
the reception room and apologize for running late,
lets the patients know that you care.
what have we learned from this incident:
Make sure the patients come first.
Take the time to make patients aware that you are taking care
of problems that have come up and you have not forgotten them.
Train your staff to be able to handle problems in an efficient
and caring manner.
Don’t forget that one unhappy patient can affect ten potential
you have a favorite patient story you would like to share email
DOES YOUR OVERHEAD
To The Periodontist
Dr. Allan Monack
Hygiene Clinical Director
periodontist is a very important part of any conservative
periodontal protocol you establish in your office. I recently received
an inquiry from Tricia an R.D.H. who works in a general practice.
“When we refer a patient to the periodontist, what information
should we include when we send a letter to the periodontist about
the patient? Is there a way to print a referral letter with the
What steps should we take to be sure the patient does not fall through
if they never visit the periodontist?”
is important that the periodontist knows exactly what you have discussed
with the patient, any periodontal treatment you have rendered, the
results you have achieved, and the reason for the
referral. I would include a copy of your initial periodontal examination,
any follow-up charting, all radiographs, and a detail history of
all treatment you have performed including any placement of intra-pocket
medications, systemic medications and home care instructions. Include
intra-oral photographs if appropriate. The periodontist will appreciate
your detailed treatment history. It makes it easier
to communicate and reinforce the recommendations you made to the
patient. The periodontist doesn’t want to tell the patient
conflicting information that may confuse the patient,
reduce the trust between the patient and the periodontist or between
the patient and your office.. This will cause the patient not to
follow through with the necessary treatment.
Jennifer Johansen, a Dentrix Coaching Specialist, says there are
many ways you can use Dentrix to enhance your referral protocol.
Dentrix provides several referral letters both to and from the periodontist.
You can print the periodontal examination, dental history, charting
and attach it to your referral letter. “Custom letters may
be created, as well, and our Dentrix support department can assist
in this process.”
The best way not to lose the patient is to prevent patient
procrastination. Explain how important it is for the patient
to seek specialist care. Have the patient fill out the normal recall
notice at the appropriate interval as if they were not referred
to the periodontist. Tell the patient they should keep the return
visit with your office unless the periodontist recommends that the
recare visit be delayed while they are undergoing treatment at the
periodontal office. Tell the patient you will inform the periodontist
of the next visit at your office. Place this information in your
referral letter. Let the patient know that the periodontal office
will contact the patient to schedule the initial
visit with the periodontist. Don’t leave it up to the patient
to contact the periodontist.
Johansen says, “To ensure that patients do not “fall
through the cracks” if they choose never to visit the periodontist,
the patient may be attached to a recall (or Continuing Care) type
in Dentrix. This will allow the office to track
how often the patient comes into the office and keep the staff informed
of when the patient is overdue for treatment.”
doctor and the periodontist should discuss your office’s periodontal
protocol. The doctors should also consider having
discussions about their mutual patients on a regular basis. In this
way communication between the doctor, periodontist, staffs, and
patients will be seamless and enhance the treatment and comfort
level of the patient and improve their chance for successful
therapy. Now isn’t that the ultimate goal!
you have any questions concerning your hygiene program submit them
to me at allan@
mckenziemgmt.com and I will answer them in future articles.
in having Dr. Allan Monack speak to your dental society or study
YOU LIKE TO IMPROVE YOUR HYGIENE DEPARTMENT?
Clinical Practice Enrichment Program is
designed to improve Hygiene Clinical Skills and develop
and implement a step-by-step Interceptive Periodontal Therapy
Program that will immediately bring greater productivity,
with enhanced patient care. For more information...GO
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2004 In Your Practice
you invest time, money, and energy taking a QuickBooks class from
your community college, check out the QuickBooks In Your Practice
workbook. Written by Susan Gunn, this workbook is the result of
frustrated clinicians wanting a workbook designed specifically for
their professional practices. A mandatory reference for any practice,
this workbook allows practices to care for patients, not figure
out their accounting software.
My practice is growing too fast. I don't mean to sound arrogant
or ungrateful, quite the contrary I can't believe how well things
are going. However, I can't seem to run on time, my schedule is
crammed with emergencies, my production numbers are good but could
be better. I'm a pretty fast worker, so it is baffling to me why
I have a 3 month + wait list.
there anything you can recommend to help increase practice efficiency.
Not just "perfect scheduling" but back office efficiency,
dentist efficiency all which would lead to increased numbers. I
don't want to hire an associate until I am sure I have done everything
in my power to maximize my potential.
Congratulations to you for determining that perhaps clinical inefficiencies
could exist prior to bringing on an associate. Adding on operatories
and associates is usually quite frequent and is not always the solution.
McKenzie Management performs clinical
time and motion studies looking at the dentist’s efficiency
and chairside utilization, instrumentation, treatment room turnaround
as well as scheduling. It’s difficult to give you “self-help”
tips but some areas of inefficiency that our team reveals are that
most dentists have not had anyone watch them do a preparation since
dental school,dentists talking too much, grabbing for instruments,
not performing quadrant dentistry, non-delegation of duties to auxiliaries,
no pre-day planning with meetings, unrealistic time for procedures,
scheduling does not reflect doctor/assistant utilization just to
mention a few. Let me know if we can be of more help.
US TRAIN YOUR
Center for Dental Career Development
Business Education for Dental Professionals
737 Pearl Street,
La Jolla, CA 92037
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