McKenzie Newsletter 383


	Monitoring Hygiene Production Developing Patient Relationships Communicating With Patients

The Dental Hygienist - a.k.a. VP of Production
by Sally McKenzie CEO
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For the record, let me say that I know most, if not all, hygienists view themselves as clinicians first and foremost. And for that, we patients are sincerely grateful. But here’s the reality: not only do you need to view yourselves as dedicated healthcare providers in your practices, you also need to assume the mentality that you are Vice Presidents of Production.

Recession or no recession, your role in the business of dentistry is critical. And being that this economic downturn is likely to linger into 2010, there is no better time than now to be doing some serious financial analyzing of your own.

Because they are employees, most hygienists never feel the need to learn business skills. In fact, some resent the fact that they are, at times, expected to look at their department from a business perspective. For many, it is not until their income or job security is affected that they recognize the importance of becoming an active participant in the business side of the practice.

Now, if you’re thinking “I’m just not cut out for that business stuff,” you had better think again. While employees may never be as personally invested in the business as the owner, the thought of taking a cut in benefits, a wage freeze, or a reduction in hours should cause a team player to pay better attention to the business side of the practice and how they can directly make a difference.

Do you know what you produce per day, per week, per month, or per year for your practice? If not, find out. Perhaps you’re thinking “why should I be concerned about what my production is per day? My priority is providing quality care to my patients. I am not here to make the doctor money.” Unfortunately, this is a mindset shared by too many hygienists. Here’s the reality: a dental practice is a business. The dentist is the CEO, but you are the Vice President of Production.

Or perhaps your view is, “I am already busy enough, I don't have time to do this.” Not true. It takes about 30 seconds to make the notations on a sheet. Monitoring your daily production is as easy as downloading the Daily Hygiene Monitor Form from the McKenzie Management website or creating your own daily log with the following information:

The date
The names of the patients scheduled - patients that cancel get a “CA” for cancel or “NS” for no show next to their name
Number of hours you are paid for that day
Open time - time that was never booked by the scheduling coordinator. All time increments should be based on 10-minute units, so a 60-minute appointment accounts
All procedures performed on each patient that day
Procedures charged out of hygiene
The total fee for each patient that day
The amount you produced that day

Once you have created your log, check off what you did on each patient and total it for that day. To determine production per hour, add up your total production for that day and divide it by the hours you were paid, not the hours you saw patients. If you’re paid for an eight hour day but only saw seven patients, you will take the total daily amount, let's say it is $1000, and divide it by eight.

Therefore, your hourly production for that day is $125 an hour. The office lost money in two ways during that open hour. First, it lost money because of open production time. Second, you continued to earn a salary during that hour.

According to the industry standard, the hygienist should produce three times her/his salary to be a full contributor to the financial health of the practice. You may find that your department is falling short, particularly if you make more than $42 an hour and produce less than $125 an hour.

However, it is important to look at the total picture. Another good exercise to do quarterly, or when raises or fees are increased, is a production per hour analysis. If the hygienist is paid $30/hour and the production per hour is $75, then her/his salary to production will not fall in the 33% range. That's okay if the next hour she/he is performing a perio maintenance or a quadrant of root scaling. Which brings us to our next point – perio.

Next week, making the case for perio.

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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Nancy Caudill
Senior Consultant
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Use Relationships to Keep Your Practice Growing

Dr. Beverly Lane – Case Study #322

More inquiries are coming into McKenzie Management regarding the loss of existing patients, fewer new patients, and the significant increase in cancelled and broken appointments. What to do?

Dr. Lane was a client of McKenzie Management three years ago. During her relationship with us, she learned a very valuable tool: dentistry is about relationships, and is not about carving the most beautiful restoration or fabricating the perfect porcelain crown.

Practice Statistics
Dr. Lane has continued to increase the number of new patients by 15% a year, even during these times. 73% of her new patients come referred by her existing patients, and the remainder come from insurance participation or a weekly ad that she runs in the local paper.

Practice production and collections has also continued to increase by over 25% each year. This year she has elected not to increase her fees. Her appointment acceptance is over 80% (not including hygiene appointments).

The Hygiene Department continues to grow. The patient retention is 92% and additional days of hygiene have been added consistently over the past three years as the indicators warrant.

Why Is She Successful?
There are only two answers to this question: She has excellent practice systems in place AND she understands the importance of having a professional relationship with her patients.

I have written many articles about the necessity of systems, so this article will not address this. Creating and sustaining relationships is equally as important in a dental practice. One requires the other.

How Did She Create Relationships?
Give yourself this test: Think of a restaurant where you enjoy dining. Now think about why you enjoy dining there. The food is good – prices are reasonable for the quality you receive – you don’t have to wait – it is well-appointed – the wait staff are personable and remember your name – they call you the next day to confirm that your meal was exceptional and to find what could have been done to make your experience even better. Do you see where I am going with this? All these considerations can be applied to your dental practice.

This is what Dr. Lane did:

Patients are greeted by name by the entire team and doctor
Her fees are not the highest and not the lowest in town
The practice is equipped with the latest high-tech equipment
Special amenities are available for patients, such as coffee, tea and granola bars
Patients are recognized during their birthday week with balloons
She calls all her new patients and any patients that had exceptional treatment
The patients are emailed or mailed surveys to inquire about ways to improve their service
Patients rarely have to wait. If they do, they are given an “I am sorry” token
There is a laptop available for adults to work on while they wait for patients

The list goes on. What I hope you see is that Dr. Lane actually likes her patients and she has team members that understand what customer service is all about.

How Is She Maintaining These Relationships?
Dr. Lane is sensitive to the financial needs of her patients. During these more difficult times, not only has she not increased her fees, she is offering incentives to her patients to help them to accept the needed treatment.

Currently, she is providing her hygiene exams free of charge to her patients. Do you think that this sales tool helps the Hygiene Coordinator to encourage a past due hygiene patient to come in? She has also offered complimentary radiographs in order to provide a complete diagnosis for a patient without insurance that indicated that she couldn’t afford them.

In order to maintain her daily production goal, the Schedule Coordinator has implemented an “On Call Program” for patients that are geographically close to the office. These patients are called on short notice and if they are able to come in, they are given a 10% adjustment to their fee.

Dr. Lane has also been known to play “Let’s Make a Deal” with her patients. For example, Mrs. Jones needs two crowns in the same quadrant. The investment was not manageable by the patient at full fee for two crowns. Dr. Lane offered the second crown for half the fee as a courtesy to the patient.

Outside Relationships that Benefit Her Practice
Not only are dental offices struggling, but the labs that service these practices are struggling as well. Dr. Lane contacted her lab and expressed her interest in offering special fees for some of her patients in order to help them financially as well as dentally. She asked if the lab would consider passing on a savings to her as well so she could pass on the savings to the patient. They said “yes!”

The Hygiene Coordinator needed a creative way to thank patients that referred new patients. She contacted several of the local restaurants and invited them to offer buy one get one free coupons that she could give to their patients. It is a “win-win-win” situation for all parties involved.

Summary
It is never too late to start creating and maintaining relationships with your patients. We don’t know how long the economy is going to suffer, but I do know this: the practices that are still growing have created a bond with their patients that can’t be duplicated anywhere else. When these practices do lose a patient to another dental office because of insurance participation, they often come back because of the relationship that was missing in the other office.

If you would like more information on how McKenzie's Practice Enrichment Programs can help you IMPLEMENT proven strategies, email info@mckenziemgmt.com.

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Belle DuCharme CDPMA
Instructor/Consultant
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Your Body Language Speaks Louder Than Spoken Words

“I can sell ice to an Eskimo” Dr. Candidly* proudly stated as we discussed the results of his treatment presentations. Observing one presentation, I noted that as the patient asked several questions, Dr. Candidly nervously spun his pen and tapped his foot with each additional inquiry as to why the dentistry was necessary. “Let’s get you an appointment and I will show you some samples of the work that I have recommended for your situation.”

Appearing to want to “wrap things up” and get the patient out the door, Dr. Candidly assumed that he had sold the patient on the dental work and his questions could be answered at a later date. The patient did appoint for the treatment, but later cancelled and rescheduled the appointment for a future date. Dr. Candidly reported that patients usually accepted and scheduled appointments but he wanted them to want the high end dentistry and not just the basic services.

Demonstrating the need for dentistry with visuals such as radiographs, intra oral photos, models and educational videos are all important. What is said to the patient to communicate the need for treatment and the benefits is also critical. Often overlooked but equally important is the doctor’s body language when discussing treatment with the patient.

From the moment you walk into the treatment room, your body is busy telling people all about you. If you have not had the opportunity to meet the patient prior to entering the treatment room, the first minute the patient sees you is spent assessing your physical appearance and the patient often does not fully hear the words you are saying until after this assessment is complete. If you slouch or have poor posture you will be sending a message of insecurity or lack of confidence. A person that stands tall and moves in a purposeful way commands instant respect as he/she enters the room. Good posture includes the way you hold your head. Study the way people in your life carry their heads and see what you think about the differences. Keeping your head level indicates an assured and capable nature. It may also give your voice fuller tones as it opens the airway. With a level head you are able to look people straight in the eye. A bowed head with eyes toward the floor makes you look unsure and passive, or possibly not telling the truth. Tilting your head shows curiosity or that you are listening to the person with interest. A tilt of the head with a quizzical look can show bewilderment or helplessness to get a point across.

Dentists often turn their backs on patients during treatment presentations in the operatory because the design of the chair and the equipment makes it difficult to sit face to face. Because of this, it is recommended to move the patient to a consultation room or private office to sit with the presentation laid out at eye level between the doctor and the patient. Often doctors dismiss this idea as being time consuming and unnecessary, however recent feedback from dentists who have started presenting treatment plans in rooms or spaces other than the treatment room find patients more willing to ask questions and proceed with treatment.

Most people are unaware of their nervous habits because they are desensitized to the behaviors and are unaware of the affect they have on observers. If you are aware of any nervous fidgeting or annoying habit that you may have, now is the time to work on eliminating it if you want to communicate effectively. One of the worst nervous habits is looking at your watch as the patient tells you a story, as it sends the message that “I don’t have time for this.”

The result is a communication disconnect with the patient, and possibly a lost follow-up appointment for dental treatment. Constantly clearing your throat, adjusting your tie, pulling at your hair, ears or chin all send messages that can make the observer uncomfortable. A relative of mine pulls at her eye lashes when she is in a conversation that makes her feel vulnerable. Because I know her habit I am accustomed to it, but others who do not know her find it disturbing.

To improve your body language and polish your treatment presentation, the Treatment Acceptance Course through McKenzie Management provides the tools and the platform to explore ways to learn how you influence your patients to buy dental services not only with your voice but also with your body. Call today to find out more about the course and how it can help you.

*name has been changed

Interested in having Belle speak to your dental society or study club? Click here.

If you would like more information on Treatment Acceptance Training to improve the performance of your team, email training@mckenziemgmt.com.

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The Dental Hygienist - a.k.a. VP of Production by Sally McKenzie CEO Printer Friendly Version

Use Relationships to Keep Your Practice Growing

Your Body Language Speaks Louder Than Spoken Words

The Dental Hygienist - a.k.a. VP of Production
by Sally McKenzie CEO
Printer Friendly Version