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6.30.06 Issue #225

 
   
The Four Rules of Staff Compensation


Sally McKenzie, CEO
The McKenzie Company
sallymck@mckenziemgmt.com

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Managing patient expectations is something that you probably focus the majority of your energy on. Makes sense, particularly since the patient is the paying “customer.” But chances are you don’t give quite as much attention to managing staff expectations. After all, the employees work for you, right?  And shouldn’t they be more concerned about meeting your expectations than whether you are properly managing theirs? Actually, this one cuts both ways.

Employees walk into employment with any number of expectations, particularly when it comes to compensation. Perhaps in their last job they received a salary increase every year. Therefore, they expect the same in your practice. And maybe everyone received the same percentage increase regardless of their performance. Thus, they believe that’s how it will be in your office. Or perhaps, you’ve started giving out a little extra throughout the year, bonuses here and there, and the team has developed a sense of entitlement –they feel they deserve that little extra on a regular basis. However, when those expectations are not met or managed, resentment takes root and begins to grow. Negative attitudes interfere. More time is spent putting out fires and dealing with conflict, etc.

If there is no established procedure or no guidelines for employee compensation in your practice, you are setting yourself and your team up for disappointment and disgruntlement. Implement the four rules of staff compensation and start managing compensation expectations immediately. 

Rule #1 – Before you give the green, spell it out in black and white. Establish a clear compensation policy. Based on the market, identify the pay range for each position in the office. Explain to every team member exactly how the compensation system will work, how much is available to the employee, what formulas are used, what it takes for them to earn more money, and how much more they can earn in that specific position.

Rule #2 – Conduct a Salary Review. Before you convince yourself that another buck-fifty an hour isn’t going to break your bank, check the balance sheet. The Salary Review is a clear and simple mathematical tool you can access immediately to determine exactly how much more money you’ll need to collect each month to cover that seemingly insignificant pay increase. It ensures that you are making an informed rather than emotional decision when it comes to salary increases.

Rule #3 – Develop a plan as a team to make more before you spend more. Every salary increase, no matter how seemingly small, has a direct impact on overhead. But staff don’t understand this unless you explain it. They do not comprehend the real costs of running a dental practice. It is very easy for employees to perceive that the doctor is lining his/her pockets with the profits unless they are educated otherwise. If the team wants to make more money, the practice must make more money. For example, consider new strategies to boost hygiene production and treatment acceptance. Take a close look at collections, and make one employee accountable for collecting money, generating accounts receivable reports, and following up on delinquent accounts. The Financial Coordinator should achieve a daily collections rate of 45% or higher. In addition, expect full payment for all procedures under $200. Provide patient financing through CareCredit. Require insurance patients to pay the portion of their payment responsibility. Reinforce your recall system, and look at your fees. They should be increased 3%-5% each year.

Rule #4 – Make staff, not the doctor, responsible for their success, their income, and their advancement. Develop results-oriented job descriptions for all staff. Involve each team member in establishing their own performance objectives that are consistent with overall practice goals, such as scheduling to meet production goals, keeping the hygiene schedule full, etc. Offer necessary training for employees to help them succeed, and provide constructive and instructive feedback regularly. Finally, hold employees accountable for their systems.

When employees have clear priorities and individual performance objectives, and when they understand how salaries are determined and what they can do to increase their own compensation, their expectations are managed and not at the expense of the practice’s bottom-line.

nterested in speaking to Sally about your practice concerns?  Email her at sallymck@mckenziemgmt.com.

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Generational Communication...


Dr. Nancy Haller
Executive Coach
McKenzie Management
coach@ mckenziemgmt.com

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I attended my niece’s high school graduation last week. The Class of 2006. One of the commencement speakers was a woman from the Class of 1956. In her address, she highlighted what the world was like when she was 18 years old. Truly amazing how much has changed in 50 years! It reminded me of the coaching conversations I’ve had with dentists and practice managers about the challenges of leading employees from different age groups.

The impact of generational misunderstanding is huge. It affects tangible costs - recruitment, hiring and retention – as well as intangible costs – office morale. It shapes perceptions of fairness and equity. Sometimes it results in grievances and complaints.

Potentially your office could comprise four different generations. Keep in mind that values drive behavior, and each generation has different values. Therefore they behave differently, and they need to be valued for what each of them brings to your practice.  Here are some facts about the people who make up your staff, and what they bring (or don’t bring) to the table.

Traditionalists were born between 1922 and 1943. These employees have a strong work ethic. Diligent and committed to resolving issues, they make valiant efforts to accomplish practice goals. They also can be resistant to change. Many of them see technology as a nuisance. They need patience when you introduce new software or equipment. Traditionalists do not seek applause. They adhere to the notion that no news is good news. But they do appreciate subtle acknowledgement that they’ve made a difference.
 
Baby Boomers were born between 1943 and 1960. They value learning. They want to be on the cutting edge. On the down side, they are considered the "Me" generation for a reason as they place heavy emphasis on money and their own emotional contentment. They favor change only if it furthers their own personal goals. As a result, Boomers can challenge office policies that don't suit their needs. Boomers are accustomed to giving feedback to others but seldom receiving it. They are used to once-a-year performance appraisals with lots of documentation.

Generation X‘ers were born between 1960 and 1980. Their main strengths include a concern for relationships and an interest in protecting the natural environment. This generation believes that treating people with respect is more important than accumulating wealth. As a result, Gen X’ers are good at building and valuing relationships. However, they give low priority to practice goals. If you want Gen X’ers to help your practice grow, you need to link those goals to individual benefits. X’ers need positive feedback to let them know they’re on the right track. And if you don’t provide enough performance feedback, don’t be surprised if you hear them say, “Sorry to interrupt but how am I doing?”

Millenials, born between 1980 and 2000, have grown up totally in the computer age. They are adept at incorporating technology in the workplace. Because Internet use became commonplace in their formative years, Millenials are skilled at accessing the surplus of knowledge available to them. On the down side, their culture of readily-accessed information has given many Millenials a demanding attitude. Since they grew up with a bombardment of electronic entertainment, they are bored easily if they're not being mentally stimulated. Millenials are used to praise and may mistake silence for disapproval. They need to know what they’re doing right and what they’re doing wrong. And they want performance feedback whenever they want it, meaning at the push of a button.

Like it or not, these generational perspectives are unlikely to change. Each generation sees things differently from the generation preceding it, as well as the generation succeeding it. I recall hearing my parents’ monologues about the long hair and the Beatles’ music of my era. To me that seems tame when contrasted with the piercings and rap music of today.

The bottom line is that you can criticize the differences, or capitalize on them. Generational diversity is one of the factors that will make your office an environment of harmony, or a battleground. Those differences can cause stress, frustration, and conflict. However, they also can become a source for creativity and productivity. 

When a team includes people from various backgrounds, and all those perspectives are utilized, the team is more effective. As the dental leader, it is your job to help your employees to accept divergent perspectives…to teach them that the whole is greater than the sum of its parts….that no one person or group has all the answers. This appreciation of diversity allows everyone to contribute and be a part of the growth of your practice.

So develop synergy in your office. Bridge the gaps and tap into the best of everyone. Create a Generational Awareness Week. Build in humor and fun. Post icons and photos that represent the generations in your staff. Include slang and popular expressions. Play music that was popular in each generation’s formative era. Encourage employees to talk about what they like about their generation, and what they wish other generations would know about them. In particular, encourage them to discuss the challenges they face at work that may have to do with their generation.

It requires flexibility and creativity to lead multiple generations. Communicate openly about how everyone contributes. Value the differences. Adapt to those differences. Bring strength to your office team.

If you would like more information to enhance your office team, contact Dr. Haller at coach@mckenziemgmt.com

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Blue Monday


Belle M. DuCharme
RDA, CDPMA

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Yes, Blue Monday is the name of a song by a British band, but to many people in dentistry, it means something entirely different.  Blue Monday is the feeling you get when you enter the office on Monday morning and check your messages to find that your two hour bridge prep appointment has cancelled due to an illness caused by some “highly contagious” virus or that the once confirmed hygiene schedule is riddled with the holes caused by week-end cancellations.  Now you are scrambling to fill open time slots or move people up to buy more time to fill the afternoon.

One office I spoke to about this problem said that they had solved it for the most part.  The Business Administrator comes in on Saturday or Sunday and checks the messages.  If there are any cancellations she tries to fill them.  I don’t recommend this for many reasons and I am sure some are obvious.  Another office I spoke to said they don’t see patients on Monday but the Scheduling Coordinator comes in and “firms” up the schedule for Tuesday.  I don’t agree with this either because Monday is typically one of the busiest days in a dental practice.

There is no solid way to prevent some last minute cancellations because things do happen that are unexpected.  There is a system to eliminate much of the problem and it requires following a few steps to create a “qualified” appointment.  A tip to the wise would be not to schedule anyone on a Monday that had cancelled on a Monday because this could be a repeat behavior.  Another tip would be to inform patients that are scheduled Monday that if they have any doubt with the appointment time to schedule for another day.  To manage your schedule for fewer cancellations and no shows follow these steps:

  1. Make sure that the patient understands the procedures to be performed, the length of time he or she will spend in the treatment room and the recovery time, if any.
  2. Make sure that the patient understands that the time is reserved only for them and that a special room and set-up has been prepared by the team to complete their work
  3. Make sure that the patient has a written treatment estimate and has paid or understands what he will have to pay at the appointment.  You must know how the patient intends to pay otherwise you may get a cancellation.  I recommend having all patients qualified by Care-Credit and offered the financing options. The interest free option is very popular.
  4. Make sure that the patient does not have an existing overdue balance and is appointed on hygiene for Monday.  I guarantee the chances of a cancellation are quite high.
  5. Make sure your Monday patients needing pre-med have their medication.  Check to see if anyone coming in needs to be off Coumadin before the appointment.
  6. Make sure that all patients understand your office policy regarding last minute cancellations and failed appointments.  Having a short statement on the Health History form is advisable located just before the signature line.
  7. Create a Short Call List or an ASAP list of patients that have agreed to take appointments on short notice.  Don’t call anyone that is not on this list because many people make special arrangements to be at your office and cannot change at the last moment.  I recommend asking everyone as you make the appointment if they would like to come in sooner should something open up on the schedule and making notes about time preferences in the appointment note section.

Have written scripts as to what to say when a patient calls to cancel.  Place these scripts in your Office Training Manual. 

Remember that a schedule that holds together is a team effort.  If the team has done it’s job by educating the patient to value the care they are given and the patient reciprocates by keeping the appointments and paying for the services, you have a successful schedule. Let’s make it a goal to take the “Blue” out of Blue Monday.

For more education on Scheduling Effectively take our on-line course here.

For more information on Professional Training for Scheduling Coordinators email training@mckenziemgmt.com.

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  July 20 Del Mar, CA - Ortho Symposium * Sally McKenzie  
   
  July 26 San Diego, CA - San Diego Womens Dental Society Nancy Haller  
   
  Aug. 2-6 Denver, CO - Academy of General Dentistry * Sally McKenzie  
   
  Sept. 15-17 San Francisco, CA - California Dental Association * Sally McKenzie  
   
  Sept. 29-30 Oviedo, Spain - Clinica Sicilia Sally McKenzie  
   
  Oct. 7-8 Krakow, Poland - UNO Dental Sally McKenzie  
   
  Nov. 2-3 Santa Barbara - The Art of Endodontics Sally McKenzie  
   
  Nov. 8 San Diego, CA - San Diego Womens Dental Society Sally McKenzie  
   
  Nov. 17 Concord, NH - New Hampshire Dental Society Sally McKenzie  
   
  Dec. 7-8 Santa Barbara, CA - The Art of Endodontics Sally McKenzie  
 
 
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