Are YOU the Practice Problem?
Jean Gallienne RDH BS
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What does hygiene breakdown mean? It usually means that the department of hygiene is not profitable or that patients are not being retained. The first and most common sector to breakdown is the lack of specific treatment assessed, diagnosed and performed, namely interceptive periodontal therapy. It is not unusual to find that the office does not have treatment protocol, or if they do have a program, it is not as productive or patient friendly as the doctor and hygienist think.
How many quadrants of root planing did your office perform over the last year compared to how many periodontal maintenance appointments and three month recall patient visits?
The amount of periodontal maintenance appointments that were done over the past year is usually much lower than what the office “feels or “thinks”. Many times the office has only charged for a prophylaxis even though root planing has been done in the past.
Why is it that the facts from the computer are different from what the operators at the chair thought? It is this lack of discovery and the knowledge to discover it that causes Hygiene Breakdown.
Is the front desk posting and billing out periodontal maintenance appointments as prophylaxis even though the hygienist clinically performed a periodontal maintenance appointment?
Is the hygienist doing the work of a periodontal maintenance appointment, but the office is only getting paid for a prophylaxis?
Is the hygiene department designed to be a prophylaxis-based hygiene department?
Once we have found where this system is breaking down we must look at how to modify and design this portion of the practice in order to benefit both the quality of patient care and the profitability of the hygiene department and the practice.
If the office starts billing all patients who previously had root planing at the higher fee of a periodontal maintenance, they are in for a very rocky road. What does an office do?
Lack of team understanding is one way this program may fail. In that case, we need to look at educating the staff on how the office’s interceptive periodontal therapy program works. The entire team will need to support each other through the times of change. Remind each other of the benefits of non-surgical periodontal treatment:
Educating the patient may be done by the individual staff members with verbiage with which the entire staff is comfortable. Not that everyone will say the exact same words, but the same message will be conveyed to the patient.
This education may also be done by an operatory DVD, booklet, or reception area DVD, such as the one designed by Intelligent Dental Marketing called, Treatment Pro, www.idmtools.com This is an affordable patient education system that may help with standardizing your team communication, improve your case acceptance, and is quick and efficient dental education for your patients.
There is a probing system, Florida Probe, which may also be used to help with educating your patients. Within the software for the probe, there is a patient education segment that may help educate your patients about periodontal disease. Adding new technology to the practice may make patients ask questions about periodontal disease themselves. This is wonderful because you now have a patient who truly wants to learn.
What does the hygienist actually do different between a periodontal maintenance appointment and a prophylaxis? This has more to do with the patient’s perception of what is different than what we, as dental professionals, know is different.
How do you convert the patient into the periodontal patient they should be, and how do you maintain them as a patient throughout the entire process? Having gone through this process while working chairside I know that it does not happen overnight..
It is easiest and most beneficial to the patient is to really evaluate all of the their periodontal conditions. If you were not doing this in the past, now is a good time to start. It is never too late. If there is still bleeding while scaling and you have been doing periodontal maintenance appointments and billing out for prophylaxis for the last two or three years, you may want to treatment plan the patient for root planing, 4341 or 4342, depending on what they need. This may be the time to refer the patient to the periodontist. This is one of the many protocols that the Advanced Hygiene Performance Enrichment Program will help your office establish.
Providing and billing out the appropriate services is instrumental not only for the health of your practice, but also for the health of the patient. Whenever the numbers for the hygiene department do not add up, it is important to evaluate where the breakdown has occurred..
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Dr. Nancy Haller
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A member of your staff is doing non-work related tasks during business hours. It might be surfing the internet, making personal phone calls, or running errands during assigned work time. Doesn’t really matter what the distraction is - he/she isn’t doing what you’re paying them to do!
In the U.S., an estimated 750 billion dollars a year is ‘wasted’ by employees at work. And studies have shown that there is a direct correlation with the amount of time people “waste” at work and their commitment to your practice.
Research has found that when the level of engagement increases just 1%, the likelihood that an employee will waste time at work decreases 5%. This equates to nearly 2 extra weeks of work per year. In contrast, when the level of engagement decreases 1%, the likelihood that an employee will waste time at work increases 4%.
No great surprise. Workers who are fully engaged are much more likely to behave in ways that benefit your practice.
The single best measure you can take to insure good staff is to hire conscientious people. Employees who are carefully screened for positive work attitudes are significantly more likely to be fully engaged. This leads to more positive relationships with your patients, more harmonious interactions between staff, and greater practice profitability.
As the dental leader, your job is to set clear objectives and hold people accountable. This is as important as "soft" leadership skills, such as empowerment, coaching and mentoring. Give employees the authority they need to do the job they're paid for. If you bombard them with petty rules, you'll prevent them from doing their job and increase your costs at the same time. Empowerment is a simple idea anyone can understand. You don’t need a slew of techniques or theories to do it. Here’s how a good leader presents a winning choice to a bad apple.
Once you have had this discussion, document it and put your notes in the employee’s personnel file. If it’s necessary to have a second conversation about poor performance, be sure to have the employee sign the written warning. Then empower the employee to create his/her own destiny. Their actions will signal their "choice". Show support. Reward them for progress, or release them from a situation that neither party is happy with.
It’s never easy to let someone go, but it is the right thing to do if that's the employee’s "choice". By following the above guidelines, your team will respect you for fair and decisive leadership. And your employee cart will be in apple-pie order again.
Dr. Haller is available to coach you to higher levels of performance in your practice. Contact her at firstname.lastname@example.org.
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