10.2.09 Issue #395 Forward This Newsletter To A Colleague
Spell Out Your Expectations
The Golden 5 Minutes
Insurance Tune Up

Locked Yourself in the Personnel Prison?
by Sally McKenzie CEO
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“You wouldn’t believe what I have put up with for the last two years.” That is how a doctor recently summed up the situation with a problem employee named Lisa.  The doctor went on to share just a few of his frustrations. “Lisa calls in sick at least once a week or has to leave early because of a “doctor’s” appointment.  She promises to take care of something, such as calling in a patient’s prescription, and it doesn’t get done. I put her in charge of sending out patient packets and she forgot to include key forms, which is why we send the packets out in the first place. Her attention to detail could not be worse. The rest of the team is ready to mutiny, but she’s great with people, so I haven’t done anything about her. However, I think it’s time… past time, actually.”

Why now, I asked, why are you ready to take action? His answer: “It’s affecting my marriage. I go home and I am so frustrated I take it out on my family. I yell at my wife. I’m short with my kids. I have no patience with the people who are most important to me, all because I’m putting up with Lisa day-after-day.”

This is the stuff sleepless nights and angst-filled days are made of. For most employers, dealing with problem staff is the most anxiety ridden of all management responsibilities. In many dental practices, doctors will go to great lengths to avoid even the slightest staff conflict, and the thought of confronting an employee can be utterly paralyzing for those who got into this profession to “do dentistry” and nothing else. Consequently, as the situation above demonstrates, many dentists will tolerate low morale, inappropriate behaviors, and utterly ineffective staff, as well as considerable personal misery. 

The key to keeping yourself out of the personnel prison is to have a solid performance review system in place from the very first day a new employee is on your payroll, and a plan for ensuring their success. However, before you can establish a performance review system, your employees must know exactly what jobs they are to perform. Ironically, it seldom occurs to dentists that they actually have to spell out specific responsibilities in the form of job descriptions for employees. The reaction is typically along these lines, “Well she worked in a dental practice before. I thought she understood these things.” Or, “I’m pretty sure we talked about that stuff in the job interview.” Or, “Don’t you think that should be common sense?” Or, my personal favorite, I’ve told them what I don’t want.”

The job description is the game plan for every position on the team, and if it’s not in place, chances are pretty good that those routine missteps will manifest into major crises with little warning. Every job description should include a definition of the position, the skills necessary to perform the job, and specific duties. Consider the following example:

1. Define the job
Treatment Coordinator: Informs patients what treatment is required, the benefits of completing treatment, financial obligations and options available, schedules first appointment. Welcomes new patients to the practice and builds rapport with new and existing patients.

2. Spell out specifically what skills are necessary for the position
Candidate must be articulate, well organized, a good listener, and sensitive to patient concerns and objectives. Must have the ability to understand and clearly explain dental procedures, the ability to work with computer systems and dental software, must enjoy working with and helping others, must be able to handle rejection.

3. Outline the specific duties and responsibilities of the job
Discuss treatment plans with doctor prior to meeting with patients. Prepare predeterminations. Conduct case presentations. Measure results using an established system, and regularly report results to the team. Monitor case acceptance. Enter patient treatment into computer system. Serve as a liaison with insurance companies regarding patient financial arrangements. Serve as communication liaison to the team and regularly report on concerns raised by patients to enable staff and doctor to address those issues. Provide other assistance as needed, including appointment confirmation, patient processing, and front desk and clinical assistance.

Be sure to avoid the common yet dangerous pitfall of overlapping job duties. Instead, cross-train so that each area has coverage, even when the point person is out ill or is unavailable. Take steps to spell out your expectations of employees through job descriptions and you’ll both have far fewer sleepless nights.

Next week: Performance Reviews - essential to building a strong “core.”

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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David Clow
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The Golden Five Minutes

Last time we met, I emphasized how important it would be for me if my dentist took time to talk with me about the immediate task at hand, and then about the big picture of my overall health. Some of you must be asking, what time? Your typical appointment with me has a specific agenda. Your execution of that agenda pays the bills. We meet in the operatory, and you do what I came for. Done.

If that sort of appointment is a staple of your business, just leave the back door open. A significant percentage of your patients will use it to exit your practice for good. For sheer practical return on investment, the time you spend communicating with me - not working on my mouth, not performing a procedure - might be the time that does your business the most good. The working time is when you’re performing the literal letter of dentistry. That’s the very least I seek from you. Chances are I don’t understand it. It might even be true that I don’t want to know about it at all. The talking time isn’t necessarily where you explain the procedure to me. It’s when you’re helping me to appreciate its value. You’re putting things in context, helping me understand not just what you did, but why, and how it makes me healthier. The five minutes you take to do this can repay you in some very important ways.

What Five Minutes Can Do For Us
First, they tell me that you view me as a person. I’d love to say that all dentists see me that way, but you and I know better. Five minutes of eye contact, friendly talk, and empathetic counsel from you is an impressive display of competency, caring, and investment - your investment in me, and your investment in your own greater aspirations. It helps me see that you view yourself not just as a repairman, but as a healer. It shows me that you won’t settle for whatever quick fix might have brought me to you on a given day, but that you want your work, and moreover your character, to make a difference in my week, my month and in all the time I’m out of your chair.

Second, that brief discussion helps me carry forward the work you did. This wasn’t your appointment, it was ours. I’m the one who takes charge when I leave your chair today, and I need to know what to do, what to expect, and what unexpected things to be concerned about. It doesn’t help me at all to make you the sole proprietor of my mouth. Your talking moments with me are coaching moments. They help me see how I help you help me.

Third, those five minutes help you accomplish everything you want your most expensive marketing media to do for you - they help make you irreplaceable. How many dentists are there in a two mile radius from you? How many alternatives do I have as a patient? If I suspect that a dentist is indifferent or just oblivious to who I am and uncaring about what I hope for and what I ask - and what I don’t know to ask - then I might look elsewhere. Sure, I understand that there are plenty of patients out there. But the time it takes you to find them and bring them in is considerable compared with the few minutes you take to give me a little knowledge and to make me feel valued by you.

Fourth and last, those five minutes might do you even more good than they do me. You didn’t go to dental school to be a mechanic. A patient who reciprocates your interest and shows you sincere gratitude is the kind of person who reminds you of your best intentions, and gives you the satisfaction you hoped to get from being a dentist. That patient makes your day. You owe it to yourself to have as many of them as you can get.

Your instincts might tell you that five minutes spent talking is five minutes lost not making money. I’d suggest otherwise. Those five minutes are my time to learn about what you’re doing, grasp its importance for my well-being, and most important, trust you. Those five minutes might be your most effective way to secure my confidence, loyalty, and interest in future care and ambitious courses of treatment with you.

On behalf of McKenzie Management, David Clow consults with dental professionals on practice culture, case acceptance, and patient expectations.

David Clow is a writer/consultant for Fortune 100 companies. His book, A Few Words from the Chair, is the first book written by a patient for dental professionals and students and is available here.

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Belle DuCharme CDPMA
Instructor/Consultant
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Tune Up Your Insurance Systems

It is amazing how fast the year can speed by, and as the holidays approach it becomes time to look at the dental insurance systems in your practice. As the contract year for most insurance plans comes to an end and the “use it or lose it” clause is eminent, it is time to gently remind those patients who have benefit dollars remaining and who need dental work done that now is the time to schedule it. For practices that can send email reminders, it is a far easier task than for those offices that have to do a mail merge and send letters. Either way, it is a must do because many patients are too busy to monitor their own benefits. You can include the following letter in recall reminders and in outgoing statements also:

Don’t Forget to Use Your Valuable Dental Insurance Benefits Before the Year’s End!

Dear Patient and Friend,

As the year begins to draw to an end, it is brought to my attention that many people do not realize that their dental plan benefit dollars do not “carry over” into the next year.  In other words, if you don’t use them, you lose them. The cost of dental care benefits is on the rise and it makes sense to use every dollar you’re entitled to. Your employer may opt to purchase a different plan next year which may not have the coverage you have now.

If you have money in a HSA or cafeteria plan that needs to be used, now is the time to schedule an appointment before the end of the year rush. The end of the year is a busy time for us as our appointment book begins to fill, so it is a good idea to call us today to reserve the best time for you. So that you can plan accordingly, the office will be closed the Friday after Thanksgiving and December 23rd to January 4th of next year. 

Now is the best time to take care of your family’s dental health and save money at the same time.

Being proactive all year round will help you to encourage patients to be aware of what their particular plan offers. At each recall appointment, take a look at the existing treatment plan to see if all work has been completed, if there are any pending pre-determinations, or if there are any procedures that the doctor is phasing for future treatment. Educate the patient at the chair and when they are at the desk, so they know what is left to do and how they can use the dollars to their benefit.

In this volatile economy no job is certain, and oftentimes benefits are cut before jobs. Patients appreciate that you want them to get the coverage that is due to them before any change in their economic situation. The key here is to believe in the long term value of good dentistry. If the patient is hedging because of the co-payment, demonstrate the value for the dollar. For instance, if the insurance plan pays 50% of a crown that costs $950 leaving $475 as the co-pay, divide that by the estimated average life of the crown (5 years minimum and 10-20 years for patients with excellent hygiene and periodontal health). That’s $95 a year for a 5 year replacement.  An excellent value considering that you use your teeth every day.

In billing procedures that are cast and will need a return seat date, consider that some plans pay on the prep date and some on the seat. Toward the end of the year, when it is possible to prep a tooth and then have to seat it in January because of the holiday schedule, make sure that you have checked the insurance rule. Don’t gamble on this one, as insurance companies often ask for the prep and seat date and sometimes want to see the clinical notes to verify the dates.

Speed up the payment of claims to keep the cash flow churning by making sure that all information entered on the claims is correct and verified.  E-claims are the best and quickest way to achieve cash turnaround. Know the rule for sending X-rays, as each insurance company has its requirements. In general, major services and periodontal services need supporting evidence and documentation. For paper claims, attach X-rays and periodontal charting if you are not sure if the insurance company wants them or not because of the delay in regular mail. 

Tune up your insurance system now or you will have a break down at the end of the year. For training on how to tune up all of your dental office systems, call today and get enrolled in McKenzie Management’s Front Office Training Program.

If you would like more information on Treatment Acceptance Training to get more patients to say “yes”, email training@mckenziemgmt.com.

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