Tackle the Number One Cause of High Overhead
Dr. Nancy Haller
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Many dentists take their employees on retreats as a way of raising the happiness level in the practice. After all, research shows that happy employees are far more productive, get better results, and are more loyal to their organizations than their unhappy counterparts. I’ve heard about some impressive retreats – all expense paid trips to vacation destinations, limousine transportation to 5-star dining establishments, spa treatments, and large bonus checks just to name a few.
While these activities will put smiles on nearly anyone’s face, the larger question is….does your team need a reward or a retreat?
A reward is a way to show your employees that you appreciate their dedication to your patients and your practice success. Rewards are good if you can afford them and – more importantly – if your team deserves them. The trouble is, while tangible recognition is a great way to reward high performance, it does not help troubled teams. And if your employees are not all high performers, those who are stars will resent sharing rewards with less productive team members.
Repeatedly I hear complaints from dentists about how much money they spent to “motivate” their team only to have continuing gossip and a lack of initiative in the office. In an interesting book, Punished by Rewards, Alfie Kohn discusses why rewards fail to promote lasting behavior change or enhance performance. I agree with his premise that rewards are based on behavioral theories. Like Pavlov’s dogs, human nature is to “do more of the same” when given a “bone.” So unknowingly – and paradoxically – many dentists are actually rewarding the very behavior they hope to stop!
Unless you have a high functioning team in which everyone is working together at the same level of peak performance, think twice about giving rewards. You can call spa treatments a “retreat” but facials and massages have nothing to do with improving collaboration among employees. If you really want to increase initiation, enthusiasm and productivity, your financial investment may yield better returns through a facilitated retreat.
Although team retreats offer both fun and education to employees, effective team retreats go beyond simple recreational bonding activities. During a team retreat, employees build bridges for results (what do each of us need to do to help the team); processes (how do we communicate, make decisions, and solve problems in the office), and behaviors (learn to give constructive feedback). Team chemistry also comes from intense training and time together.
If you are considering a team reward (even if you are calling it a retreat) ask yourself the following questions:
Although no team is perfect and even the best teams sometimes struggle with one or more of these issues, the best dental practices constantly work to ensure that their answers are "yes." If you answered "no" to any of these questions, your team may need some work. And by all means be very careful about rewarding undesirable team behavior.
It’s easy to lavish employees with gifts and incentives, but real leadership courage means acknowledging those things within your reach that you can change to make your practice function better. You may believe that your employees are a team, but perhaps they are just a workgroup. To find out, conduct a simple survey. Individually ask each employee to tell you: 1) the practice’s mission, 2) what they are trying to accomplish, 3) the priority of their specific tasks, and 4) the degree of collaboration between staff members. You may be surprised how differently they interpret the team’s goals, and how much they are functioning as individuals rather than a unified team. Team synergy occurs when a group achieves greater results together than they could accomplish individually. And it’s in your power to create that!
Send your questions to Dr. Haller at email@example.com. You’ll receive a complimentary executive summary of Maintaining Team Performance.
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Tom M. Limoli, Jr
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My company has tracked dental fees for the better part of the last quarter century. My father collected both international and domestic fees and fee schedules the same way some people accumulate postage stamps and coins. His detailed analysis of data was nothing less than a labor of love for his profession and how it functioned within the confines of differing world economies.
The tracking and reporting of dental fees is no different today. The sluggish economy complicated by rising unemployment and government intervention in the free market system is challenging capitalism as we know it. And guess what? All this shows up in the fees charged by doctors to their patients.
Not so long ago, it was common for dentists to raise their fees annually by 2% to 5%. These fee raises were usually across the board, modifying each and every procedure code. But those days have gone by the wayside. The act of balancing fees is an art form pioneered by my father in his original 1984 textbook entitled The Dental Consultant Looks at Insurance with your Fee Schedule. He and I perfected the process of fee balancing and relative value with our original 1995 text Fee for Service Dentistry with a Managed Care Component. In short, Limoli and Associates (www.LIMOLI.com) is the most accurate source for a comprehensive fee schedule analysis.
So what does the current fee data show? In many parts of the country, dental fees are stagnant. We are not seeing dental fees statistically drop but we are seeing areas where the data has reached a plateau and is no longer in a growth posture. I see this also occurring as fewer and fewer dentists are routinely marking up their individual fees simply because the calendar says so.
In the few areas of the country where fee data is consistently rising, I see these increases as the effect of simple procedural reality. Artificially deflated fees simply and naturally rise as greater numbers of various procedures continually occur in that geographic area.
These two previous observations are complicated by the economic reality that many people simply have little or no confidence with the integrity and potential prosperity of Wall Street. People are holding on to their cash because they fear (real or perceived) yet another drastic economic shift. Too many analysts are still saying the financial situation is going to get much worse before it begins to get better.
Three things have to happen before the economy begins to grow on a foundation of rock rather than sand.
In other words, business as usual is dead and gone. Old solutions are not going to fix the new economic problems that caused most of us to lose almost half the value in our Wall Street - based financial portfolios over the last year.
And what common denominator do all three phases share? The answer is fair market pricing. Fair market pricing is the amount of money that a willing buyer pays to acquire something from a willing seller, when a buyer and seller are independent and when such an exchange is motivated only by commercial consideration. What we are talking about is your unrestricted usual fee.
So where do your fees fit in? Is your data higher or lower than that of your neighbor? Is it that way by design and intent, or do you simply not know? Stop basing the future of your practice and fee schedule on randomly generated statistical percentile calculations. Now is the time to have your fees professionally analyzed. Your potential as well as active patient base is shopping for quality, price and value. Unfortunately, not always in that same order. But then again, aren’t you?
If you are interested in having a comparative Fee Schedule Review 7 page report detailing 216 of the most often performed dental procedures compared to your existing fee schedule compiled for your zip code, please email firstname.lastname@example.org.
Tom Limoli, Jr. is the prevailing expert on proper coding and administration of dental insurance benefit claims. He serves as president of Limoli and Associates/Atlanta Dental Consultants, Inc., a company that over the past quarter century has assisted dental offices in streamlining the insurance reimbursement process.