for an Associate?
Base the Decision on Reality not Illusion.
Contrary to popular perception,
it’s not the long days, missed lunches, or rapid-fire schedules
that dictate the need for an associate. Those may be good indicators
that staff and systems aren’t functioning properly, but they
aren’t the signal to throw another doctor into the mix. When
it comes to determining the need for an associate it’s the
hard data that spells out the black and white, the yes or no, the
stop or go in the search for an associate. Inefficient systems
can create the illusion of a busy practice, but the actual
number of patients may tell a very different story.
another doctor is brought into any practice, there must be enough
patients to not only keep doctor and associate busy but support
the two. How much is enough? The industry dictates that
a solo general practitioner must have a minimum of 2,000 active
patients – not 2,000 patient records in the system. That number
should be projected to double within two years if an associate is
speaking, industry data recommends that for a solo practice to remain
healthy it should have a monthly new patient flow of 16-25,
and 85% of those new patients should be accepting treatment. Although
there is more flexibility for practices that have a 20 year history
in a community and a solid recall, every practice needs new patients
knocking on the door. And practices that are eyeing the resumes
of potential associates should be seeing at the minimum, new patient
numbers in the area of 40-45 per month before the practice is ready
to make the investment in a full-time associate.
addition, the practice must carefully consider a host of other critical
details. McKenzie Management works with practices in developing
a 40-point needs assessment in which numerous specific
considerations are evaluated, including:
your present method of scheduling patients maximized?
Are you delegating procedures to an assistant?
Are you as efficient as you could be?
What days and times would an associate be needed?
What level of experience does the senior doctor
expect the associate to have?
What types of procedures will the associate be expected to perform?
How much compensation is the doctor planning to
Will the compensation be on a salary or commission basis?
If the associate’s compensation is based on a percentage will
that percentage be dictated by collections or production?
What, if any, practice expenses will the associate be expected to
pay for, such as lab expenses?
Will the associate have management responsibilities?
And many more.
it comes to bringing on an associate, don’t skimp on the details.
The impact of this decision will reverberate with the doctors, the
team, the patients, and the bottom line for a very, very long time.
And the reality of a poor choice will snuff out the illusion of
that happy partnership quicker than the ink can
dry on your agreement.
you have any questions or comments, please email Sally McKenzie
in having Sally speak to your dental society or study club?
to Employees with Personal Problems
Dr. Nancy Haller
A top-notch hygienist in my practice just called in sick for the
coming week. She told me that her doctor diagnosed her with OCD
(Obsessive Compulsive Disorder) and prescribed Zoloft. I know she’s
had some personal problems but I’m not sure how much to get
involved. What’s your advise?
your interest in employees without
too deeply into their lives requires good judgment and
tact. It’s important to care about employees. People
who are cared about in turn show caring to others. They
work more efficiently and are more congenial. Effective
leaders have empathy…the ability to understand and
respond to others, to see the world from someone else’s perspective,
to step into their shoes.
Perhaps you believe that work and personal life should be separate.
You may have been told to keep a healthy distance from employees.
work environment has changed. Work is more than a job and
a paycheck. It is a place where people spend 30, 40, 50,
60 or more hours together a week. Good leaders know more about their
employees than just the work they do. And employees expect
some compassion from bosses and co-workers. They need personal
validation. Being impersonal signals disinterest and a lack of caring,
and is as risky as being overly involved.
his book, Primal Leadership, Daniel Goleman describes empathy
as the key to retaining talent. Although a positive relationship
with a boss is not enough to produce worker productivity, it can
significantly contribute to it. And the absence of sensitivity can
lead an employee out the door. At the same time, you need
to strike the right note in your interpersonal relations with your
staff. It is important to be approachable and friendly,
yet fair and firm.
may be that you are worried about saying the ‘wrong thing’:
shouldn’t take it so hard.
It could be a lot worse.
You’ll get over it.
Just pull yourself together.
Those statements minimize a person’s pain and convey a lack
of interest on your part. The impact is negative and potentially
damaging to your relationship.
how should you handle the situation?
An emotional problem is really no different that a physical problem.
Although we live in the 21st century, it often amazes me how little
we have advanced from the Salem witch-hunts when it comes to our
acceptance of psychological disorders. Think about how you would
respond if your employee had a broken ankle, or a surgical procedure.
your hygienist to the office when she returns.
It’s good to have you back.
how she is doing.
How are you feeling? Are things okay?
Step two in showing empathy is longer listening.
Be patient. Refrain from interrupting. Nod appropriately. Maintain
good eye contact and display interest in your facial expression
concerned without becoming a therapist.
She already has a treating professional. Don’t get into
the counselor role. Avoid giving advice or probing for
details. Most people work through problems and issues
very well on their own. Simply expressing concern is greatly appreciated
and often enough.
objective. Redirect if necessary.
The office is a place of business. Keep personal disclosures to
a minimum. If your employee becomes too self-revealing or rambles,
manage the time by gently redirecting the conversation to a close.
Sounds like you have a lot on your mind. I’m
glad you are seeing a good doctor. Let me know if you need time
off for appointments. You’re an important member of our
dental team and I want you to continue to feel better. Welcome
back. (Pause). I’ll let you get back to your patients now.
performance is being affected, meet informally with the employee.
You indicated that your hygienist was ‘top-notch’,
but if productivity and/or office behavior declines, it’s
important to follow-up. Show genuine concern and not
‘gossip’ style interest.
Some subjects are not matters of public discussion in the workplace.
These include situations such as your hygienist’s emotional
problems. Keep quiet about personal problems employees bring to
you. The exception is when problems involve breaking the law or
today’s increasingly complex world, even rock-solid workers
are likely to have times when their lives are affected by a personal
crisis. At some point, you probably will be faced with an employee's
family, financial, legal or health crisis. The skill and
humanness exhibited by you, the leader, will be important
in the final outcome.
Haller is available to speak to your dental society or study club
on subjects such as interpersonal communication, conflict management,
and team building. If you would like information about any of her
practice-building seminars, contact her at firstname.lastname@example.org
or 1-877-777-6151 Ext. 33
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the Patient’s Perspective
has been a means of self expression, a symbol of individuality,
an indication of wealth or social status, a token of affection and
appreciation for tens of thousands of years. Even cavemen sought
to decorate themselves with bones in their hair and ears. In Victorian
times, men wore more jewelry and more
elaborate jewelry than women, a trend that eventually reversed.
the 1960s, everyone was wearing jewelry and piercing
became a means of making a statement. Men were joining women in
piercing their ears. Sexual preferences were announced by wearing
earrings in a specific ear. Today, young men and women have taken
body piercing to a whole new level. Earrings track from one end
of the ear to the other. Jewels adorn noses, eyebrows, lips, bellybuttons,
dentists are well aware, tongue piercing causes chipped teeth, recessed
gums and nerve damage, but as more dental and medical journals are
reporting, this fad could be fatal. Most patients don’t even
consider the harmful ramifications of imbedding
jewelry in their mouths. Yet that new decorative hole in the tongue
now provides the ideal pathway for bacteria and organisms in the
oral cavity to find their way to other parts of the body including
the brain and the heart.
to Karen Murphy R.N. of Morton Plant Hospital in Florida, “surgeons
have recently seen patients in their teens and twenties needing
open heart surgery to replace a diseased valve.”
This means younger people are having major surgery and will have
to take blood thinners for the rest of their lives. It also means
that they may have to have a prosthetic valve replaced every fifteen
or twenty years.
2002 the Yale School of Medicine reported that an abscess detected
in the brain of a young woman was probably caused by an infection
resulting from having her tongue pierced one month earlier. In addition,
piercing has been identified by the National Institutes
of Health as a possible vehicle for transmission of hepatitis
B, C, D and G, and HIV. What’s more, young people who have
their tongues pierced are more likely to engage in other high risk
behaviors such as smoking and using drugs.
are plenty of good reasons why young people should avoid tongue
piercing, yet too often the sense of invincibility is far more convincing
than the sense of reason. But dentists can influence their young
patients and one of the most persuasive tools is pictures.
Telling patients that their “sexy” studs are hazardous
is one thing, showing the danger in living color is another. However,
like any potentially sensitive discussion between doctor and patient
it requires a careful approach.
the patient that you are not judging their looks or style. However,
you have genuine concern for the life and wellbeing of the patient
and his/her family. This puts the discussion on a personal
level –it’s not just facts and statistics.
The approach should be oriented toward a discussion regarding dental
hygiene and health. Let the patient give you the reasons for the
jewelry ornament or ornaments and listen closely. Listening
builds confidence between you and the patient. It makes
the patient feel that you care. If you listen to the patient, there
is a good chance that the patient will listen to you.
if the patient still will not remove the tongue jewelry and allow
the hole to close? You could continue to provide care and take your
chances with the patient’s health. Or you could follow the
lead of a New Jersey dentist who has made a strong statement. He
refuses to work on any patient that has tongue
studs or an open hole in the tongue. He has not lost one family
because of his decision. The parents at the next visit thank him
for taking the time to explain to their child the dangers of tongue
jewelry. Most of the young adults do come back to him after the
hole has closed up and never have another hole put in their tongue
has provided physical ornamentation for tens of thousands of years,
its purpose, however, is to enhance beauty, not
DOES YOUR OVERHEAD
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.
Missed Past Issues of Our e-Management Newsletter?
I feel that you have a true understanding of the numerous situations
(that are mainly negative) with bringing on an associate dentist.
have a special request--many of us have children that become dentist--this
happened to me and his coming into my practice was a disaster. We
had been so very close before he came into the practice, and things
happened that were just crazy!!!!!!!
you have any insight on this part of a situation?
Thank you for your email. Yes, I have observed, first hand, your
situation many times over the 25 years I've had this company. Just
because you're the father doesn't mean that it is your obligation
to provide an opportunity for your son. Sometimes the opportunity
isn’t even there, i.e., patient base to support another dentist.
Just because you are biologically from the same gene pool doesn’t
mean that your philosophy of dentistry will mix or your personality
types will be the same and then there is the issue of “you’re
the father” who protects the son, controls and makes all the
decisions. If your son is still in the practice, my recommendation
would be to have us in the practice, as an outside objective expert
that would "level" out the playing field for both of you
and make recommendations to provide one path to a common vision.
Let me know if I can be of help.
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La Jolla, CA 92037
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