10.5.07 - Issue # 291 Forward This Newsletter To A Colleague
Shoppers to Loyal Patients
Office Managers
4 MM Pockets

Turn Today’s Dental Consumer into Tomorrow’s Loyal Patient
by Sally McKenzie CEO
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Before the person walking into your practice ever becomes a patient, they are a consumer. And when they’re evaluating your practice against the others they are looking at it with the critical eye of a customer who is about to make a large investment in both time and money in what they hope will be a long-term relationship. Make the most of a few critical determining factors – service, reliability, stability, expertise, and price.

#1 Service is number one because consumers expect excellent service, and it is one of the most essential but often overlooked factors that will instantly set your practice apart from others. Excellent service begins with the first phone call and continues with every interaction thereafter. Something as simple as welcoming all patients – new and existing – to the practice by name when they walk in the door conveys a sense of appreciation and good service. Looking patients in the eye when you speak to them and when they speak to you tells them you are genuinely interested in what they have to say and you are sincere in what you have to tell them.

Keeping your cool even though it may be one of those “full-moon days,” and treating each individual as though they are the only patient you have to take care of today puts the patient at ease because they feel the practice has things well under control and their best interests at heart. Knowing the answers to common questions, and providing thorough and complete information tells them you have your act together and are well trained/prepared. Similarly getting back to them when you say you will with the answer to a question indicates that you value their interest in your practice. 

#2 Reliability - Patients expect the office to run reasonably on time. If the doctor or hygienist is behind schedule, telephone patients so they can make changes in their plans or reschedule if necessary. If you can’t reach the patient and they have to wait for more than 20 minutes, give them a letter signed by the doctor that apologizes for the inconvenience, thanks them for their understanding, emphasizes that the practice makes every effort to remain on schedule; however, occasionally special circumstances arise that affect the schedule, and include a $5 gift card to a Starbucks or a similar gift in the envelope.  The patient may still be frustrated about the delay, but they will appreciate that the practice acknowledged the inconvenience. 

#3 Stability – A solid team is the mark of a strong practice. If Ann is at the front desk when the prospective patient calls, but has been replaced by Nichole when the patient comes in for their first appointment who is later replaced by Joe when the patient returns for treatment, you can bet that this new patient is going to develop concerns about the stability of your practice. If the make-up of your team seemingly changes as often as the seasons, patients begin to wonder about things, in particular, the quality of your care and the competency of your staff, and often those concerns are for good reason. If yours is a revolving door practice, it’s a strong indicator of some serious shortfalls in your personnel systems, including hiring, training, employee evaluations just to name a few.

#4 Expertise – Brag about each other. You simply cannot overemphasize the expertise of the doctor and the team. Take every opportunity to convey the message of excellence and quality. If a patient asks a team member if the doctor is good at a particular procedure, answer with an emphatic “Yes! She/he is the best.”

The new patient packet and the practice website should give information about the entire team’s training and experience, particularly the doctor’s. Routinely, inform patients about continuing education classes staff have participated in. This is as simple as placing an 8 x 10 frame at the reception counter that highlights the staff member’s accomplishment. For example, “Please join us in congratulating Dr. Jones for her recent certification from the American Academy of Cosmetic Dentistry.

#5 Price – Make it easy for patients to accept treatment and pay for that treatment. Provide clear financing options that are both practice friendly and patient friendly. Partner with a patient financing company, such as CareCredit. These firms provide excellent financing options that benefit both doctor and patient.

Make the most of what you have to offer today’s consumers and you will be far more likely to enjoy them as your patients for many years to come.

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

Interested in having Sally speak to your dental society or study club? Click Here.

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Belle DuCharme CDPMA
Instructor/Consultant
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Halloween is around the corner. Are you the Good Witch or the Bad Witch “Office Manager”?

From the case files of McKenzie Management Advanced Business Training

Dear Belle,
“I am the Office Manager for a 3 doctor practice.  Two GP’s and one endodontist part-time.  We have a staff of 8 and also 3 hygienists.  The doctors put me in charge of ‘managing’ the staff about a year ago.  I have worked in this practice for ten years and can do anything in the back or in the front.  My problem is that the staff has labeled me the ‘BBB’ because I am in the position of making unpopular decisions concerning raises, time off, job duties etc.  Some days I feel like a ping-pong ball and I am getting headaches trying to balance all of this.  I am looking forward to the Advanced Training Course with you and McKenzie Management.
Suzie M.

Suzie M. came to McKenzie Management for the Business Course for Office Managers with an open mind and a commitment to making things better in her practice.  Together we defined the areas that needed improvement in all business systems and then we worked on the specific issue of staff management.   We changed her title to Business Administrator to dispel the negativity that the title “Office Manager” had implied.

Since she had worked in the practice for ten years, there was some resistance to her promotion. Not every practice has a Business Administrator who is involved with staff management duties. Very often, these duties are that of the dentist CEO. We often find that people placed in this position are ill equipped to handle staffing issues as they arise, but can benefit tremendously with coaching and training.

Before coming to the training, I asked Suzie to provide the practice’s Mission Statement and practice Vision.  In order to get this information she needed to meet with the doctors and share with them goals and performance expectations.  She found this to be very insightful.  Also important to the training was the “Office Policy Manual” and job descriptions for all staff members.  “We haven’t looked at the job descriptions for a few years and there are a couple of new employees who do not have job descriptions; our policy manual is very basic and does not cover every question I get from the staff”, explained Suzie.

After defining job descriptions and areas of accountability for all staff members we were able to set up standards for performance measurements.  Performance reviews are not salary reviews.  A performance review can be given when there is questionable performance and includes a timeline for improvement or on a yearly basis if there are no outstanding issues. McKenzie Management has an excellent Performance Measurement Manual to take the guesswork out of developing this system.

We addressed the Office Policy Manual that they had and identified necessary changes to cover issues of time off, raises, job performance etc.  Having a standard office policy establishes a system that everyone must operate within. Studies show that people work more productively if there are standards in place and a clear understanding of office policies.

We next discussed Suzie’s role as the Business Administrator.  Developing a “team-building” attitude was necessary for Suzie’s success in her new role.  Consider the following when developing a system for meeting the needs of the team.

  • Vision for the practice and where each team member fits in to the picture stressing the importance of their contributions.
  • Training and support to get the job done.  Includes computer software training, customer service training and other technical training.
  • Respect for each other’s work and an understanding of how each contributes to the success of the practice.
  • Communication about how each individual is doing with job feedback on an ongoing basis.
  • Solutions to barriers.  The staff needs to feel they can come to you for answers to problems.
  • Freedom to do their jobs at the best of their abilities without being micro-managed and stymied.  Freedom to suggest new ideas without criticism and judgment.

Very important to “team-building” for Suzie was to get the doctors involved and supportive of the training that she had received.  A suggestion was made that the new team attend a Team-Building Retreat offered by McKenzie Management and directed by leadership coach Nancy Haller, Ph.D.

For more information about our courses and products for success, call today and speak to one of our McKenzie Management professionals.

For more information on McKenzie's Advanced Training Programs for Office Managers and Front Office, email training@mckenziemgmt.com, call 1-877-777-6151 or visit our web-site at www.mckenziemgmt.com.
Interested in having Belle speak to your dental society or study club? Click Here.

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Jean Gallienne RDH BS
Hygiene Consultant
McKenzie Management
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To Root Plane or Not to Root Plane

What exactly needs to be root planed? This of course is a clinical decision that needs to be made by the health care provider, not the insurance company.

However, the decision to root plane or not to root plane needs to be made based on the individual needs of the patient.  Setting a policy that anybody 4 mm and above need to be root planed will help your patient retention to decrease rather quickly. Otherwise the patient is being treated as a number and not the individual that they are.

Whether the patient is a new patient or a patient of record that has been treated in your office by your hygiene department for years, the clinician should be doing a thorough review of not only the health history at every visit, but also their dental history. Even if it is a matter of looking back over the past three to five years in the patient’s record in order to see where the patient was and where they are now. This also applies to the new patient.

The reviewing of the new patient’s past dental history is imperative in order to determine what treatment may be recommended. Some of the questions that you may want to ask:

When was your last dental visit?
What was done at your last dental visit?
When was your last professional hygiene appointment?
Do you floss?
How often do you floss?
How often do you brush?
What type of brush do you use, a mechanical or a manual?
What name brand is the brush that you use?

Once you have completed charting existing restorative conditions and you are starting to look at what needs to be done, if there is an existing crown that needs to be replaced,  this is an excellent time to ask the patient, “Mr. Jones, this tooth is going to need this crown replaced. Do you know when the crown that is currently on it was done?”  This will help the front office when it comes to going over the financials with the patient that has insurance.  This is also a good time to ask the patient who has missing teeth how long ago the tooth was extracted. Of course they will be more than likely be giving you an estimated amount of time. However, the more information that is provided to you and your staff about existing treatment will help in providing the most accurate information when the financials and treatment plan are gone over.

Another time to ask questions is once the radiographs are developed and you have completed the periodontal charting with the patient  who is actively participating in the co-diagnosis. If the patient has 4 millimeter pocketing or more, it is important to know if they have ever been root planed before and if so, when. If it has been less than two to three years, some insurances will not cover root planing and it is important for the patient to know prior to treatment what estimated cost will be coming out of their own pocket.

Now, when it actually comes to the need for root planing, we all know that pocketing alone is not the only diagnostic tool that we should use when treatment planning root planing. We also will want to evaluate bleeding upon probing, bleeding during instrumentation, radiographic bone height, tissue color, shape, and attachment loss.

Medical history is also important.
Is the patient a diabetic?
Taking medications?
What medication does the patient take?
What are the side effects of the medications?

When this patient presents himself or herself to you for their dental healthcare needs they are coming as an entire package. Medical, dental, personal lives, stress levels etcetera. They are not only coming as a 4-millimeter pocket.

What if Mr. Jones had root planing in another office and there is no bleeding upon probing, bleeding upon instrumentation, and the tissue color is pink and firm, does not have any medical concerns, the patient flosses daily effectively, brushes after every meal, but has 4 millimeter pocketing? Is this a patient that needs root planing?

This is just an example of how a patient with a 4 millimeter pocket may actually be maintaining it, and should be continuously monitored at their periodontal maintenance appointment rather than jumping in with root planing because they have 4 millimeter pocketing.

Take the example of Mr. Smith that has been seen in your practice every 3 months for years and they are diabetic, flosses on occasion, and has two 4-millimeter pockets in the maxillary and mandibular right and left quadrants. With heavy generalized bleeding during instrumentation, but no bleeding upon probing. Is this a patient that needs root planing?

Now, Mr. Smith is another story, and he is a patient of record and wants to know why he needs it now even though none of his pockets have changed. One way to explain this to the patient is, “Mr. Smith, we have been able to slow down the periodontal disease process for many years now. However, with your history of being a diabetic, not flossing on a regular basis, and the heavy bleeding that is present at this time indicates to me that you are losing ground when it comes to the health of your mouth. When there is bleeding present, this is not healthy. We need to be more aggressive in order to slow down the disease before the probing depths get deeper, and root planing is the most conservative approach at this time. In the future if we do not see your health improving we may want to refer you to a periodontist.”

This is an example of a verbiage that may be used or modified at your office when working with patients of record. This patient will now become a periodontal maintenance appointment every 3 months. Unless the health of their mouth improves so much that there is no periodontal disease then they become a prophylaxis.

So, in order to determine if root planing is needed, it is recommended to ask questions verbally in addition to reviewing the medical and dental history, evaluate bleeding upon probing and instrumentation, radiographic evidence of bone loss, and the shape and color of the tissue. 

Interested in knowing more about how to improve your hygiene department? Email hygiene@mckenziemgmt.com.
Interested in having Jean speak to your dental society or study club Click Here.

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