Staff Appreciation in Lean Times: Priceless
Dr. Pat Charles – Case Study #310
Dr. Charles contacted McKenzie Management because of low production, no systems, and staffing issues. She bought an existing practice with 826 active patients that had been in its present location for seven years. The stand-alone office is located close to a middle to upper income neighborhood. She installed new equipment in her two operatories and left the existing equipment in the two hygiene rooms. The same furniture remained in the reception room. The sign outside was the same except her name replaced the previous doctor’s name.
The practice is 28 years old, and it looked 28 years old! Over dinner, the subject of “practice cosmetics” was discussed. “I honestly don’t pay any attention to the office. I come in the back door, head right to my private office for the morning huddle, work all day and leave the same way I came in” was Dr. Charles’ response.
Dentists work in a space as large as the patient can open their mouth and this is where the decorating and re-arranging is done. The objective was for Dr. Charles to consider applying the same thought process to the physical structure of the practice.
The outside sign was outdated and dingy. It was not illuminated, making it difficult to see at 4:30 when it starts to get dark in the winter evenings. There was sufficient parking behind the building on a high-traffic street. However, it was noted that the team members had the “choice” parking spots closest to the sidewalk. Upon arriving at the front door, my first observation was – spider webs! The doormat was old and worn. I opened the door and entered the reception area…a tiled floor. It was clean but every footstep echoed and it felt very “sterile.” The plastic chairs were all lined up against the wall, just like you find in the ER waiting room at the hospital. They had seen better days. A copy of Glamour Magazine from June of 2006 was proudly displayed on the coffee table. There was a large print of Yosemite National Park on one wall beside the plastic weeping willow tree.
It was recommended that Dr. Charles contract for the creation of a logo for the practice, as well as update the outdoor sign to include the new logo and illuminate it for viewing at night.
Dr. Charles was just not cognizant of looking at her office from a patient’s point of view. Whoever cleans the office should have a check-list to bring attention to areas such as spider webs, fingerprints, etc. She was also asked to consider covering the tiled floor with a nice sound-absorbing area rug and to replace the outdated plastic chairs with a comfortable sofa and armed chairs. Be sure to have armed chairs that are easy to get out of. Arrange the room like a living room in a home. Add sofa tables and lamps. Throw away the plastic tree and use live plants instead.
What type of pictures you place on the wall is certainly a matter of choice. Many doctors choose their own photography but if it’s not “personal” to you and you have a choice of Yosemite National Park or a family with beautiful smiles which one will better illustrate what you do and set the tone for the patient’s visit? Consider setting up a DVD monitor and playing information about cosmetic dentistry so patients can be educated to possibilities.
Business team members should be dressed in business attire. It is important to have this discussion when placing a new employee in the business area. Establish guidelines on what is and isn’t acceptable in the business area. Dr. Charles’ Financial Coordinator is presenting thousands of dollars worth of dental treatment and dressing appropriately exudes knowledge and professionalism.
Conclusions: Six months later on my return visit, there was a different atmosphere. She had placed a refreshment center in the reception area for coffee and tea, as well as granola bars and a small dorm-sized refrigerator for cold water and juice. The old plastic chairs were moved to the staff lounge and comfortable, attractive seating was placed in the reception area, along with a very nice area rug.
Dr. Charles was so surprised at the number of patients that commented to her about how long it was going to take before she “remodeled” and how much they enjoyed the new décor. Her investment was small compared to the new attitudes of her team members and positive feedback from patients.
I challenge you to walk through your front door and see what your patients see. Does your office need an “Extreme Makeover?”
Setting up clearly written financial options for patients before beginning treatment is the only way to eliminate most collection problems. When patients understand what is expected of them, they are more compliant in paying when payment is due. There are fewer misunderstandings that lead to heated phone calls about statements received after treatment is complete.
Financial options should include a financing company such as CareCredit that will allow the patient to make affordable monthly payments based on their credit score and credit worthiness.
Recently, I have received inquiries as to what to do with patients who owe under $100.00 when phone calls and statements have been ignored for 90 days. The patients in question have received a course of treatment and have paid most of the fee or have insurance that has already paid per contract. For the most part, these patients have been compliant in the past. Because sending a patient to a collection agency has negative implications for both the patient and the practice, it is wise to take a different approach on small balances. In the past I have used what I call a “compassion letter” for patients that owe small balances. When patients owe the practice money, they usually don’t return to the practice until the bill is paid. Some patients are angry that the practice is “hounding” them for such a small amount and they may make disparaging remarks about the practice to friends and neighbors to justify non-payment. The compassion letter is an unexpected random act of kindness that can often result in payment. The letter reads as follows:
Write Off Compassionate Letter
After repeated attempts to communicate with you by statement and by telephone regarding your overdue account, I have decided to write off the amount of ________ (money) that you owe Dental Practice (name). I do this with the understanding that financial problems can happen despite best intentions. Should you decide to return to our office, we require that you pay your past balance to reinstate your account.
For now, your record will be inactivated and my business manager will be happy to forward your dental records to your new dentist if you wish. Please do not postpone regular visits to your dentist as this will only create larger more expensive health problems in the future. I have enclosed some educational information that I feel may be of help to you.
Before using a collection agency, consider the following:
It is important to schedule regular reminders before considering a collection agency. This will not only help save money, but will also avoid the negative outcome that can be generated when using a third party to collect the funds.
As a final step, set an absolute due date before the account is turned over to a collection agency. Do not extend this date, but do give the debtor warning of this final payment date.
How Agencies Work
Collection agencies can attempt to collect on bad debts by phone and by letters. Smaller debts may not justify the cost of phone calls, limiting the collection agency to simply sending threatening letters.
Choosing a Service
It's hard to predict a firm's success with delinquent accounts ahead of time. Investigate when choosing a collection service.
Method of collection
Examine the letters that will be used and judge whether they will be effective with your patient base. Ask about the training that telephone collectors receive to ensure that they understand the Fair Debt Collection Practices Act. This 1977 act requires that debt collectors treat debtors fairly by prohibiting certain methods of debt collection.
How the service will work with you
Ask how information about delinquent accounts will be transferred to the agency and when collected funds will be forwarded to you. When and what type of reports are provided detailing the collection progress and success rates? How you can stop collections if you receive payment or credit an account?
Reputation of the firm
Make sure to check references and find out whether the firm complies with state licensing or bonding laws.
Debt collection is usually done on a contingency basis with commissions ranging from 10% to 60% of the recovered amount. Other agencies require an upfront fee and then take a lower percentage of the recovered amount.
Make sure the agency you choose is licensed
Some states require collection agencies to be licensed in their state before they can pursue debtors. Contact the American Collectors Association (612-926-6547) or a particular state's collection agency administrator for specific details on state requirements.
To avoid collection problems by improving communication and improving cash flow by setting up financial payment systems in your practice, consider training your front office team with one of McKenzie Managements’ Advanced Training Programs.
If you would like to learn more about McKenzie Management’s Advanced Training Programs, email: firstname.lastname@example.org.
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