Patient Dismissal Tough Act to Follow
Up goes the chair. Off goes
the bib. “Good bye Mrs. Patient. Thank you for coming in to
see us today,” says Doctor as he/she dashes out the
door. The procedure is complete; get the patient out of
the chair as quickly as possible; move on to the next operatory.
“Be sure to give us a call if you need anything else,”
says the happy assistant as she trots out after the doctor on her
way to the next operatory. Anything wrong with how this patient
dismissal act is going? What’s the big deal? It’s
a perfunctory exercise that every office carries out over and over
and over again. You have to keep things moving, right?
at the reception area, Ms. Front Desk is answering the phone, greeting
incoming patients, and trying to fill a hole in tomorrow’s
hygiene schedule. Here comes Mrs. Patient winding her way toward
the front desk alone. Where’s the record
spelling out what procedures doctor performed today? It’s
not there and she’s not carrying it. Where’s the charge
slip telling Ms. Front Desk how much she is to charge
the patient? It’s nowhere to be found either. Is Mrs. Patient
supposed to come back for follow-up care? Dunno.
Front Desk greets Mrs. Patient through her gritting teeth. Peering
down the hall, she hears the instruments whirring away, quietly
seething she wonders silently, “Where in the
heck is that blankety blank chart.” Waiting for the patient
record, she tries to fill the void with a little small talk. “Isn’t
this fall weather gorgeous! I just wish it could stay like this
all year.” Whirr, whirr go the instruments in the operatories,
still no chart. Mrs. Patient is getting antsy.
“Can I just go ahead and pay my bill? I really need to get
to another appointment.”
Are you starting to see the problem? Doctor and assistant aren’t
taking the time to finish up with one patient before they move on
to the next. It’s their responsibility to
make sure that the completed patient record is in the hands of the
front desk staff before they dismiss the patient. Without it, Ms.
Front Desk is stuck having to adlib. The spotlight’s on her
to perform, but she can’t. She can’t collect from the
patient. She can’t schedule the patient’s next
appointment. Instead she can either ignore the patient,
which is unacceptable, or she can engage in mindless, time wasting
chatter with the patient, which is also unacceptable not to mention
in a fit of total exasperation, she is forced to take matters into
her own hands. Excusing herself, Ms. Front Desk dashes down the
hall. She’s in search and rescue mode now
desperately trying to get her hands on that patient record. Streaking
in and out of operatories, she searches the lab, hygiene, even the
break room before finally discovering the chart on the doctor’s
desk - incomplete. There Mrs. Patient stands waiting and waiting.
The phone has been ringing but no one is at the desk to answer it,
and patients are scattered about the waiting room because no
one was there to check them in.
performance of Doctor and assistant in dismissing this patient is
not just a tough act to follow, it’s virtually impossible
for the front desk staff to perform at all. And the only thing Mrs.
Patient remembers is she had to practically beg to pay her
bill and get out of the place.
week, make sure you have your act together for patient dismissal.
you have any questions or comments, please email Sally McKenzie
in having Sally speak to your dental society or study club?
You Disciplining Employees Effectively?
Dr. Nancy Haller
are human. Mistakes happen. No matter how skilled,
savvy, or well-intentioned, your staff is bound to slip-up
at one point or another.
normal to feel uncomfortable with discipline situations because
dentists are not trained to deal with the sensitive interpersonal
dynamics involved in changing unacceptable employee behavior.
There is a temptation to avoid putting yourself in a potentially
confrontational situation. But face it – a poor
isn't going to get better unless he or she is made aware
that there is a need to improve. By concentrating on the desired
results rather than the employee's perceived shortcomings, you can
improve the chances of a positive outcome.
The challenge is using mistakes to impart knowledge, to
expand skills, and to develop heightened awareness. Unfortunately
for many, the word discipline conjures up negative images
and knee-jerk reactions .... memories of being grounded and privileges
denied. But the word is frequently misunderstood.
root of discipline is disciple…a student. To discipline
then means to teach. Discipline is to correct more
than to punish behavior. If you want employees to be productive,
you have to create a disciplined, teaching environment.
Discipline is really a part of overall performance management.
research has identified perceived fairness as the key to
effective employee discipline. Discipline has been found
to result in positive attitudes and behavior when it is perceived
as being applied in a fair manner.
are some practical steps to raise responsibility, promote accountability,
and enhance learning.
your personnel manual.
Every dental practice needs sound, straight-forward policies as
well as clear and concise job descriptions. Failure to do so leaves
your employment-related practices vulnerable to challenges, grievances
and possibly lawsuits, particularly if you are inconsistent in
how you apply your policies and your pay structure/system. Of
course, be sure to communicate rules regularly to employees.
Only in a true emergency should you act without thorough planning.
Do your homework. Research the situation until you have verified
what the facts are and know that action is necessary. Anticipate
how the employee will respond. Practice what you are going to
say and in what sequence. Know your own communication style, how
you are perceived, and how you will react in the event of a challenge
or emotional outburst. The emphasis is on coaching the employee
to do better. Knowing what you intend to cover in a face-to-face
meeting, and sticking to the agenda, is much easier if you have
planned in advance.
Have a conversation with your employee.
Ensure confidentiality. Discipline should never happen in front
of others. Remember the purpose is to teach not embarrass. Identify
the problem as you understand it. Be brief but specific. Then
offer the employee an opportunity to present their side of an
incident. There may be a factor you didn't know about that will
help the two of you to solve a problem jointly. Refusing to listen
just builds resentment and makes improvement difficult. Be fair
to the employee. Consider his or her side of the story and any
evidence submitted. Never criticize the individual, but rather
focus on the actual behavior.
Stay focused on work-related issues.
You should act as promptly as possible while the incident is fresh,
but you need to make sure you've got the facts. Parties may also
need a little time to cool down. The conversation must be business-based
to be appropriate. Also, avoid addressing more than one or two
concerns at a time. If necessary, schedule another meeting.
There often is a misunderstanding about what and when to document.
All disciplinary infractions should be recorded in some form.
For minor, first-time offenses, write a note to remind yourself.
The employee need not know about this, and it does not require
formal entry into a personnel file. If the problem reoccurs or
if it is a serious offense, be sure to formalize the process by
having the employee sign the document.
Know how you will monitor the work situation to ensure that the
behavior change occurs.
Discipline normally follows a series of defined, documented steps
of increasing severity. The usual sequence is verbal warning,
written warning(s), suspension or layoff without pay, and discharge.
Only the most serious offenses require immediate discharge, but
after careful investigation and documentation. Always confront
an employee whenever there seems to be a discipline problem.
You can learn to give feedback well. You must practice to improve
your skill level until the complex process of putting together
all of this material becomes second nature. Help your employees
achieve the overriding mission – to be successful in their
careers and in your office!
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
Executive Coaching Help YOU Be A Better CEO?
this test to find out ...
the Patient’s Perspective
the late 1990s the “Mozart Effect” sent the long deceased
composer’s piano sonatas to the top of the charts. A study
at the time had indicated that listening to Mozart resulted in higher
scores on certain IQ tests. Although skeptics disputed
the Mozart theory, the powerful effects of music on people have
documented. While it won’t necessarily make you smarter, study
after study demonstrates that in many cases music truly can “soothe
the savage beast.” And when it comes to managing anxious
patients or simply making patients more comfortable in
the dental setting, music can be a supplementary analgesic of sorts.
has been shown to be effective in distracting patients from pain
or discomfort and as a means of prompting relaxation.
In a report issued by the University of Iowa, the author noted that
“Music can act as a competing stimulus to pain, thus reducing
perceived intensity of pain. Music with a slow,
steady tempo can also be used to cue slow, steady breathing and
can trigger a relaxation response. These uses of music can be integrated
into cognitive pain management protocols during surgical and other
medical procedures, (and) during dental care …”
only does it benefit the patients, depending on the selection, it
also might affect the productivity of your staff. A 1994 study reported
in the Journal of the American Medical Association found
that when people listen to music in the background, it is very important
that they listen to music that they are familiar and comfortable
with. While you may choose what you consider to be relaxing music,
it won’t necessarily have that affect on your team or your
patients if they are not familiar with it or if they don’t
study of 50 male surgeons was conducted to see if they performed
a basic surgeon-related task better and more efficiently while listening
to music chosen by the surgeon, “experimenter-selected
music,” or no music at all. The test monitored the
surgeons’ pulse rate, blood pressure, speed, and accuracy.
The selected music was Pachelbel's Canon in D. The studies with
music showed significantly better results than the study without
music, but the study in which the surgeon selected the music the
effectiveness was even greater.
kind of music is best for your practice? For your patients? That
likely depends on a number of factors from age,
to socio-economic factors, to geographic location of the practice.
What’s more, it’s likely that the selection can’t
be narrowed down to just one type of music.
first the patients, although you may or may not have any savage
beasts coming into your office, you do have patients that need to
be soothed. Many practices have invested in the
therapeutic benefits of music by supplying patients with individual
listening devices and a choice of musical selections.
preferences are likely to be as varied as your patients. For example,
teens and young adult patients may prefer Hip Hop and Rap.
These have a strong, fast beat and extremely fast vocal sounds and
rhythms. The rhythm can be catchy and people have a tendency to
get caught up in the beat.
perhaps Country music is the selection of choice.
Today country music is perhaps at its highest peak in popularity
thanks to mega-stars like Garth Brooks, Reba McIntire, and Faith
Hill. Or maybe Elvis is in your building. Rock and Roll
continues to enjoy enormous popularity. Your staff may lean more
toward Hip Hop and Country, but your baby boomer patients are probably
going to be looking for their selection of favorite rock and roll
tunes. Swing, of course, would be the music of
choice for many WWII generation patients along with crooners such
as Frank Sinatra and Bing Crosby.
Jazz, Classical, New Age, Easy Listening, Honky Tonk, Reggae, there
are numerous types of music that can be enjoyed by you, your patients,
and your staff. Maximize the therapeutic effects of music
by giving patients access to music they are familiar with and enjoy.
Consider trying different types of music in your office to determine
which provides the soothing or energizing effect
you are looking for.
DOES YOUR OVERHEAD
look forward to each new day with my team, and what we
will accomplish today that will create the tomorrow that
I want. I am happy because I feel in control again. I
am happy because I understand my and my team’s role.
I am happiest to have my feelings of fear, for the future
of my practice, diminishing daily and being replaced by
am looking forward to having my finger on the pulse of
my practice again. Thank you McKenzie Management.
WANT TO BE
An easy and effective method
to measure your dental employee’s performance
employee performance is a dreaded task for most dentists. Now it
will be easier using objective performance measurements that are
specifically designed for the dental practice. These extensive,
ready-to-use appraisal forms help you measure an employee's performance
based on everything from Job Descriptions to Productivity to Work
Ethics and Cooperation.
Performance Measurements kit includes an extensive workbook with
copy-ready appraisal forms and measurement graphs to use for each
employee. In addition, you will learn how to determine the number
of employees needed for a successful practice, how to design results-oriented
job descriptions for all business and clinical staff, use performance
charting to objectively measure your employees, and make sound hiring
and firing decisions.
Missed Past Issues of Our e-Management Newsletter?
My employer wants me to sell hygiene related products to the recall
patients. I don’t think it’s professional. What is your
Hygienist from Pennsylvania
Obviously when your employer asked you to sell products chairside,
she did not expect you to dismiss the request. You work for and
are paid by the dental practice and if the practice will do better
through the sale of products, it is incumbent upon you to do your
part. Believe me, when chairside sales are conducted professionally
and appropriately, they can be a win-win for both the practice and
patient. Look at this example, if you were at your favorite pancake
house and you tell the waitress how much you love the flavor of
the blueberry topping. She mentions that they have had so many compliments
and requests for toppings “to go” they now have bottles
of it available for purchase. Do you feel like the waitress is “selling”
you? Of course not! She is just providing a “news flash”
about the availability of something you might enjoy taking home.
This is the key to chairside product sales – offering patients
premium products that would otherwise be unavailable to them. Just
having the products displayed in your operatory and having the patient
use some of the products usually prompts conversation quite naturally.
“I am going to recommend that you use this toothbrush,
dentalfloss, mouthwash or toothpaste. Just give this “prescription”
to Mary at the front desk and she will be happy to fill it for you.”
You’ll be surprised by how many patients return thanking you
for the recommendation.
OUT OF YOUR
Center for Dental Career Development
Business Education for Dental Professionals
Pearl Street, Suite 201
La Jolla, CA 92037
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